1710 Maritime Oak Dr revision CITY OF ATLANTIC BEACH
r /rte�0 800 Seminole Road
r is v Atlantic Beach,Florida 32233
) 9 Zp�6 Telephone(904)247-5800
J V O SEP 2 FAX(904)247-5845
LJr ON T SHEET
Date: 0Q7 ao aOII.P ived by: 0Resubmitted:
Permit Number: {%a F — t -
Original Plans Examiner: Project Name: "Qr1{1 G DWCh OTUHA
Project Address: 1-h11D MAylf'Irn>; 01K Dr. - W In
ContmCtor:TDLContact Name:
Contact Phone :CICU- cr I5- 5aL43 Contact e-mail:-j�jr-G
Revision/Plan Check/Permit Fee(s)Due: $ 5-0,610
Description of Pronged Revision to Existine Perini[.•
AdAifAto
j � i Ah I
Additional Increase in Building Value: Additional S.F.��
Site Plan Revised: ^ ,,t,� Public W/U Approval:
By signing below. I(prim mum) Tom' '1 R_o�S affirm that the above revision
is inclus' e �f+ e proposed change
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Signature Of Contract Ag6nt(cm nutter must sip ifirmrtme in Massimo Dat—C r
�t // Office Uce Only
num: 10-3 Approved:_X _ Re}ctd: NotiaWby:
Plan Review Cy O S mmenis:
_ f= _Ss���*_��7 Eo✓l�art co,a7�rac%x.- -�'�,r
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Department review required Yes No
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