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125 DONNER RD - REVISED A-3 01M-..,6 CITY OF ATLANTIC BEACH J� ' \�t1 800 Seminole Road AAtlantic Beach, Florida 32233 l s) Telephone(904)247-5800 FAX (904)247-5845 "J13 J' REVISION REQUEST SHEET OR 10 1Z1Ho CORRECTIONS TO IEW COMMENT Date: Received by: (A Resubmitted: Permit Number: /(, _ 51--74T— M93 Original Plans Examiner: Project Name: Project Address: /Zs Po,vve2 Rol _--- Contractor: iI.rc lvsla„ /4.,..4s r '4'04 o s Contact Name: 5— •../". Co tact Phone : 99oy- 686 - `/g(8 Contact e-mail: \ Re isi Plan Check/Permit Fee (s Due: $ 50,00 /7-/ Description of Proposed Revision to ExistiI --Permit: --- Z"° Flom as vgtg 4- 4/ Ali Afe4 A-v/4i e D I --- 3 Additional Increase in Building Value: $ Additional S.F. 9/ Site Plan Revised: ublic W/ U Approval: By signing below. I (print name) JA "-e 1�-elle affirm that the above revision is inclusive oft roposed changes. C -' - / F-/� Signa re Contractor/Agent(Contractor In t sign if increase in valuation) Date Office Use Only © n �] rE Date: /0//0' /6 Approved: A Rejected: . `( v led by: t SEP 1 9 2016 I Plan Review Comments:zip rove Sv tom, He 64 / 1 co/lira cime- Pd Z --I o cc)to y ent review required YtIo Buildin – ;4 �-- Planning &Zoning Tree Administrator Pl. 9xamigjZ- 130 Public Works id./016 �_____ Public Utilities 10 Public Safety Dat - Created 4/13/16 Rev.3 Fire Services