367 BELEVEDER - REVISION SHEET /, „1_,,:\J„,, \ CITY OF ATLANTIC BEACH
,J. - 800 Seminole Road
V.91Atlantic Beach,Florida 32233
: ,,, s) Telephone(904)247-5800
J FAX(904)247-5845
Ao1319r REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: L2/2 e/2 0/ Received by: Resubmitted:
Permit Number: I Co - RW -1507
Original Plans Examiner: Project Name:
Project Address: .5-6 7 :6.---/e✓ 1 --1e._
Contractor: m �e ,o4 ' di, Contact Name: C !'h SY`S -11
Contact Phone : i -5 . S -9 93' Contact e- ail: 735 # AL .Q1" _�
IIMIMEIMIF
Revision/Plan Check/Permit Fee(s)Due: $ 5 C,O C)
Descri tion of Proposed Revision to Existin Permit:
.� _ Amp - Q�Qn9Q PRaii1eQrc /1
c3
404 prtA. v
-{ S`4o, Li `i'ke S °.r» e_
l
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W�/U Approval:
By signing below. I (print name) J p/1 l�J `F-, . (cp 44S `. affirm that the above revision
is inclusive of he propo angel.
WA /? u,/ZO/ 6
.'_ - e wc.. actor/Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: Approved: Rejected: Notified by:
Plan Review Comments:
4\rit7 .c5 Nre• y t$ L -rt.'p
Department review required Yes No ;�r�_
��wilding
Plannll g&Zoning
Tree Administrator Plans Examiner
Public Works O tv 7 1 'T,
Public Utilities11 J i
Public Safety
Date Creased 4113/16 Rev.3
Fire Services