296 ROYAL PALMS DR - COMMERCIAL HOOD PERMIT s r\J\f J
:� .� CITY OF ATLANTIC BEACH
S 800 SEMINOLE ROAD
- V ATLANTIC BEACH, FL 32233
�; INSPECTION PHONE LINE 247-5814
COMMERICAL ALTERATION/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-COTH-197
0 Job Type: COMMERCIAL OTHER
Description: commercial hood
Estimated Value: $1,500.00
Issue Date: 3/1/2016
Expiration Date: 8/28/2016
PROPERTY ADDRESS:
Address: 296 ROYAL PALMS DR
RE Number: 177613-0000
PROPERTY OWNER:
Name: KLOTZ, JEFFREY DAVID
Address: P 0 BOX 330833
GENERAL CONTRACTOR INFORMATION:
Name: RIVER CITY FABRICATION INC.
Address: 2911 BURKE ST
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $57.50
Total Payments: $61.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
HI!ILDING CODES.
\ CITY OF ATLANTIC BEACH
\si\ 800 Seminole Road
` , .t �: j Atlantic Beach,Florida 32233
?> ;r Telephone(904)247-5800
FAX(904)247-5845
� J;31Sf'
REVISION REQUEST SHEET
Date: /0—/0 Received by: Resubmitted:
Permit Number: ((o — Cad r hi--/ 7
Original Plans Examiner:Ti A.R.r. tOti;ia,J Project Name:Row.z. ,D,4_,..„ t '
Project Address: , , , • °A-colt-5 T1 N'
' c �� �L 3..2.Z
Contractor:/�iC/4-c c (apt Pe-s
f,vg,a7Lontact Name: d 64.0e c 2 ce�P4 t e/PM/i D✓aKa,Contact Phone : 90 V 3 9 !v s y
Contact e-mail:R I v�2 c,r'y i 2�l//&/ito L. ('ox.k
tgevision)Plan Check/Permit Fee(s) Due: $
Description of Proposed Revision to Existing Permit:
Coa -rc ��a—A)%5
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name)---V)140/("Z .J d -0 14/14.1"„A/ti O,,v,-J 422 affirm that the abeverevision
is inclusive of the proposed .1 :: .
Signature of Contractor/ k L� o w`��2 ��%
Contractor must sign if increase in valuation) Date 1
Office Use Only
Date: Approved: Rejected: Notified by:
Plan Review Comments:
_�e_ p4 42-- S Um. FL.4.ti S Asa mo.4�t P Mme-=-- >��s� Go t),_., \.l
r� („,...,„,,_ fie.
gi en review required Yes No
Building lding
&Zoning
Tree Administrator
Public Works
Plans Examiner
Public Utilities (
Public Safety O 2.- ) \ t 6
Fire Services Date
Created 8/20/15 Rev.2