567 COASTAL OAK LN - REVISION PRODUCT APPROVAL 0 LAN:rly,
, CITY OF ATLANTIC BEACH
:) ' . - ‘- ' ,
800 Seminole Road
Atlantic Beach, Florida 32233
A f r s) 7 ,7''l ,N r Telephone(904)247-5800
!�' =r g -�+- i FAX (904)247-5845
J'31,� REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: 1 '30 -1'1 Received by: Resubmitted:
Permit Number: Ito 5S)( 'IlrLp
Original Plans Examiner: is'l. )o►scProject Name: /-/,c l e ac. L
Project Address: •T 7(. ' COASML OAt L-nu
Contractor: CvaStat Cp&icS (.0 051% Contact Name: (,n zE6 )341.../417
-
Contact Phone : 470- z-.z9• v 6/7_,-2.- Contact e-mail: 9 rr 5 e_,e,0A5/•,o A,tS d U 0$firvc(,o v•C U re)
Revision/Plan Check/Permit Fee (s) Due: $ ,jO.Oe
Description of Proposed Revision/ to Existing Permit:
,PV'u" -P/r1t�/C/e.f xtera✓AFail..✓t 7°r• f jti/-
(....t.,
"C. '"^"1- ops Dua r-S
Additional Increase in Building Value: $ --- Additional S.F. ' 6
Site Plan Revised: C) — Public W/U Approval:
By signing r-low. I (print name) C'ir.JG 7)-S4,z...4-7 r affirm that the above revision
is inclusiv- If the proposed changes.
.� _ - /" 30 '17
Signatur 7� on=. /Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: / ` 3 J— / 7 Approved: X Rejected: Notified by:
Plan Review Comments:
/71pyroveci as Svbrr,, ti•o'/
j gents. 17 con iv°(-Ion 4 /, `k-t/
foto sof-- ,pay f?e. .
rtment review required Ye/ No ��
Building V -
Plannln -Zoning Plans Examiner
Tree Administrator
Public Works /
Public Utilities —_ ` -" yr-I?
Public Safety Date Created 4/13/16 Rev.3
Fire Services
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CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
02,01;2017 15:38:47
CREDIT CARD
VISA SALE
CITY OF ATLANTIC BEACH
XXX 1128
800 SEMINOLE ROAD Card:, 3
ATLANTIC BEACH, FL 32233
PHONE (904) 247-5826 Bath
h: 292
Batch 4: 3
Cashier Id: atlbcld\atlbbja INVOICE
Receipt Date: 2/1/2017 3:39:44 PM 05338
Receipt Number: 0S-72331 Approval Code: Manual
Enty
Job ID: I6—SFR-1820 — NEW SINGLE FAMILY RES Mode
Method: Online
M
IDENCE 82 - BD PLAN REV. 2ND SUBMITTAL $5 Mak' M
0.00 Card Code:
Amount Due: $50.00U
Tender Information: Cash $50.00 SALE AMOUNT U
Tender Type: CC
Tender Amount: $50.00
Change Due: $0.00
CUSTOMER COPY