1877 Beach Ave revision sheet CITY OF ATLANTIC BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
Telephone(904)247-5800
FAX(904)247-5845
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REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: �y� Received by: Resubmitted:
Permit umber: 1A, 9S $
Original Plans Examiner: Project Name: /li�,
Project Address: 'J^y y�
Contractor:/ /R-a-h _A/0yirs, Contact Name: ♦ L
Contact Phone : .S� f $'f r/S
Revision/Plan Check/Permit Fee(s)Out
Descri tion of Pro osed Revision to Existin Permit:
l,.e7�fe edty*eewt No src
Additional Increase in Building Value: $ tI5 Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name) —�qA6- t"4– affirm that the above revision
is inclusive of the proposed changes.
y/g�
Si r of Contractor/AgLrnt eC rmmor must sign if e,e..in valuation) Date
office Use Only
mApproved: X Rejwr d: ri by:
Plan Review Comments:
S b o 4Ocl
DgpAWent review required Yes No
Building � }'
Zoning U
Plans Examiner
Tree Administrator
Public Works
Public Utilities ! ! b
Public Safety
Fire Services Date c�u�sna ar.s