292 16th St revision sheet CITY OF ATLANTIC BEACH
AMk 800 Seminole Road
Atlantic Beach,Florida 32233
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OFFICE COPY Telephone(904)247-5800
FAX(904)247-5845
REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: Received by: Resubmitted:
Permit Number:T-1717
Original Plans Examiner: Project Name:e V;ave
Project Address: a((el- '"� b4cwt '
Contractor: 5 Contact Name:
Contact Phone :q(1lt-1'5S—C*'X\ e-,,
Revision/Plan Check/Permit Fee(s)Dug!$ .$��.D O
Descrition of Pro osed Revision to Eaistin�mit:
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U15 td otic �1 C ' JoS�.
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below. 1 (print nerve) ti"(l yaw. 50' J t affirm that the above revision
is inclusive of the sed than
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Signature Comtrac(or/Agent(Conaaaor most sip if Increase in valuation) Date
y' Office Use Only
Dater —93-16 Appmved: /� Rejected: Notified by:
Plan Review Comments: /
&Vra�c�Su /OM)fLy rcrll Con1rCrC1aX- rho P' Ll- ,P dCAD
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aliment review required Yes No m
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