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1764 MARITIME OAK - REV.5/16/16 ‘,. 1.1.v./:[)-‘,..' , MAY 1 6 , a ,CITY OF ATLANTIC BEACH J Iy� , � /BY: LDis 800 Seminole Road kri �`°''' --��� Atlantic Beach, Florida 32233 J : 1r Telephone(904)247-5800 FAX(904)247-5845 REVISION REQUEST SHEET • Date: 5 13 I i (D Received by: Resubmitted: Permit Number: Ito -SFR- 1095 Original Plans Examiner: . Project Name: Project Address: 17(0q-- I\AAAZI'T t M e © K Z Contractor: To►t BrollICYS I n G Contact Name: -1z __— Contact Phone :004)&95 6243 Contact e-mail: arot 17) lb XS •Q,OI'✓) Revision/Plan Check/Permit Fee(s)Due: $ Description of Proposed Revision to Existing Permit: WU) S rte 10.v► leo" -t ro g h 1Y ivt w -- Additional Increase in Building Value: $ Additional S.F. Ni 1,4r Site Plan Revised: Public W I U Approval: By signing below. I(printnamc) qc affirm that the above revision is inclusive of the pr•.•sed changes. " i/ L - ___-5.�(31-1(0 Signature o ontractor/Agent t litnsl sign if increase in valuation) Date -- ---- — - office Use Only .. © U V E Dute: Approved: Rejected:---- I ickl by MAY 182016 Plan Review Comments: Li , De•artment review required Yes No :utldin.� • t = __---_ anntng &Zonin• . Tree Administrator_ �•'• Ic Works Plans Examiner 'r•.lic Utilitiede_ —�--- u.lic Safety --- Fire Services _ ... _ Date Created 1/20/12 Mc 2