1024 MAIN ST - REVISION REQUEST T- 1r\ijs>..
J�' CITY OF ATLANTIC BEACH
800 Seminole Road
. J Atlantic Beach,Florida 32233
J Telephone(904)247-5800
FAX(904)247-5845
1J;iJv.)r
REVISION REQUEST SHEET
Date: y-/5-149 Received by: Resubmitted:
Permit Number:
Original Plans Examiner: tune.
n A-rlrn fir) Rip Project Name: /I(aS-krs eesielence
Project Address: /042f )(G(n S i,1
Contractor: I/'C cver era I Con fra G}or.S Contact Name: jehhrki ,Si,o )
Contact Phone : goy-aqp yy/( Contact e-mail: 00 fern r CA/jao e. evil-)Revision/Plan Check/Permit Fee(s)Due: $ 9
Description of Proposed Revision to Existing Permit:
Inc/ -Ron.l-poi ch f dd j Jvrrn door I- p[� a q f; MI nada
-/�'hyt-f were apprvvvd In /face*r bedroom area .JAh/- a a
Bard) ,njkridr" t ex-tenor .
Q nd�>7on�d ,c/�acic.
Additional Increase in Building Value: $ 7/p i� Additional S.F. $ /35
Site Plan Revised: Public W/U Approval:
By signing below.I(print name) Jehni-A( Sh U0 affirm that the above revision
is inclusive of the or sed changes.
i
.i
.,.iature a e-4/5-/b
Contractor/Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: Approved: y Rejected:
Notified by
Plan Review Comments:
PI„.......Ei,„E
ILL 1_iLl/i'
-
D-- a fitment review required Yes No
ri MP.
- m. &Z.I'e.
-- administrator
Public Works Plans Examiner
Public Utilities 01//(Public Safety
Fire Services
Date Created 8/20/15 Rev.2
j�
'" J" s1
CITY OF ATLANTIC BEACH
y- i
800 Seminole Road
�^- -,1 Atlantic Beach,Florida 32233
'.5 Telephone(904)247-5800
FAX(904)247-5845
01319'
REVISION REQUEST SHEET
Date: '1-/5-/40 Received by: Resubmitted:
Permit Number: /6 - $P 4 '3.7 P
Original Plans Examiner: n Ayla lr)�111P Project Name:
Project Address: /ON S/jee
1�AS fers �PSiCLe/IC(
Contractor: i /'C (,ienera I Confra G1aor_S Contact Name:
Contact Phone : cad -
y a yy/
ye- & Contact e-mail: SennrFa n
Revision/Plan Check/Permit Fee (s)Due: $ Jennr C��eyc. et)/Y7
Description of Proposed Revision to Existing Permit:
. r. a.. 4- .•.o :.d sir// :aor , / .
I ...' 1 Ail*1 'I /a pia i 4 are/ Na,'- /0 . ho�e�
A rr ) oiler'.r t e -Ierio r . r ace .
Additional Increase in Building Value: $
Site 7�p 0-p Additional S.F.��
ite Plan Revised: 5
Public W/U Approval:
By signing below.I(print name) Jef/1kI I Sn(r2d affirm that the above revision
is inclusive of the .r. sed changes.
/ V
/Agent(Contractor must sign if increase in valuation) Date1nature, 'Contrtor;
Office Use Only
Date: 1.-/`c2/— /G Approved:_ f ' Rejected:
r Notified by:!Plan Review Comments:
rllv1
roU aS Subms, 2016
V w ' CC7!? G ox.. - ,f/ _ v
.Cop y.
D- •moment review required Yes No
• ng& .,'1.
-- A dministrator
Public Works laps Examiner
Public Utilities 41 ad I.1.6
Public Safety
Fire Services
Date
Created S/20/15 Rev 2