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574 TIMER BRIDGE LN REV REQ *;:�.L _ �1 �,, _ CITY OF ATLANTIC BEACH �`� �\ 800 Seminole Road J \ ,. . ,I , '`SJ TLE COPY Atlantic Beach,Florida 32233 ��'Lr Telephone(904)247-5800 FAX(904)247-5845 REVISION REQUEST SHEET Date: 51 LP/ 11.0 Received by: Resubmitted: Permit Number: 15-SFR-2-4-10 �t- Original Plans Examiner: Project Name: M lanhc. Bec_! ach l�un-Yt, 01(6 Project Address: 67 114 -firy t r Pari ( La Contractor:'1-O 11 l3 rOche1PrrC j InG Contact Name: l Contact Phone : clog-eq °J 2'-5 Contact e-mail: Or P-f ll br .wry) Revision/Plan Check/Permit Fee(s)Due: $ Description of Proposed Revision to Existing Permit: ft-Gla it'o In oP ©lAtdOOr Silow-e-ie.• .__. 141 ilu . Additional Increase in Building Value: $ Additiona S.F. Site Plan Revised: Public W/U Approval: By signing below. [(print name) it. I ' PK r• " affirm that the above revision is inclusive of the •._.posed changes. �• I I 5/Loif(P Signa lire of ontractor/A_-t(Contractor must sign if increase in valuation) Date Office Use Only Date: i 7 /& Approved: 1 ' Rejected: - Notified by: Plan Review Co ents: 0 rove 05 sti to n9 + Dj ,e; /_, 4 6,- ab n e0✓ T;10 4 h•e I/ rr,Eeol c/p kv Con ac ine. --------- c_ps.partment review required Ye-No • Buildi ' 7/ rn s-'..-- anning & on siratef— Plans Examiner Public Works Public Utilities 5---/ 9-/6 Public Safety Fire Services ( Date Crested 8/20115 Rev.2