363 4TH ST - STAIR REVISION . ��-���frJ�� FILE COPY
CITY OF ATLANTIC BEACH
• ss� 800 Seminole Road
Atlantic Beach,Florida 32233
J � —• � Telephone(904)247-5800
FAX(904)247-5845
REVISION REQUEST SHEET
Date: 21 APtz.V, Received by: Resubmitted:
Permit Number: l5- i 42.I
Original Plans Examiner: toktim, Project Name:
Project Address: 34,5 .k- it
Contractor: txt„ N t Contact Name: lA\c,tk,.. 'g, Rc
Contact Phone :q,54.ems,3- Contact e-mail:vg,tooLt, Dv,AR cd}1Th-Gr Ise-e..(—inn
Revision/Plan Check/Permit Fee(s)Due: $
Description of Proposed Revision to Existing Permit:
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—c , \S 146-c- )4 -b s pAaLaMw- . #v-ovl 'l TimiLa, t 1- v
Wt6v-e. t*Avoiteruitrusak
Additional Increase in Building Value: $ / Additional S.F.
Site Plan Revised: PAD ! Public W/U Approval:
By signing below. I(print name) tyVt-i b A stkovg r, affirm that the above revision
is inclusive of , e roposed changes.
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Sign ture . tr. tor/ gent(Contractor must sign if increase in valuation) Date
�/ l /- Office Use Only
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Date: / r d I t7 Approved: n Rejected: Notified by:
Plan Review Co ents: Na ` D /
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ma 7 c7 eN 3 �7^ et N Kelm'� i Sy S'ie , ///o)v tt Co rl Jr d CToJ-
- ?2k- ). 6 cal.!
Department review required Yes o
Building t�Lt
Planning &Zoning
Tree Administrator Plans Examiner
Public Works
Public Utilities
Public Safety
Fire Services Date Created 8/20/15 Rev 2
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