705 SAILFISH DR REVISION REQ �, CITY OF ATLANI'1C BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
J Telephone(904)247-5800
FAX(904)247-5845
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REVISION REQUEST SHEET
Date: 6'"---20 —ll.. Received by:
Permit Number: _ A 4 , .. 5, _____--------- Resubmitted:
Original Plans Examiner:
Project Address:7Gf So/1-F/S rtmContractor: /►SAM l �L 3�t
Contact Phone :_______________Is .S3S' 7g5-6Contact Name: ceE�� T'^,�, Ai
Revision/Plan Check/Permit Fee(s)Due: Contact e-mail: 4442.A1 . Sr
Description of proposed Revision to Existing permit: ---NI
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L L' A417-6 A,4 ,t ??E 441 G'ri�c..c,6 nay IE V� E Q V E
111.1111111.1111111 I
_ AY i 20
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Additional Increase in Building Value: $
Site Plan Revised: Additional S.F.a
Public W/U Approval:
By signing below.I(print name)�E',G � I1�it,,,E,y
is inclusive of the proposed changes. affirm that the above revision
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Signature o n actor/Agent(Contractor must sign if increase in valuation) Date /
Office Use Only
Date: 5-� 3 ,/c, Approved:
Rejected: Notified by:
Plan Review Comments: e
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6 Co roc eX zo�o CO 40 liZeo/"v
Department review required Ye No
Building
Planning &Zoning
Tree Administrator
Public Works Plans Examiner
Public Utilities
Public Safety 5%. 3• 6
Fire Services
Date Created S/20/15 Rev.2