2190 FAIRWAY VILLAS S - REVISION FOR DOORS (coLApt e, CITY OF ATLANTIC BEACH
t; " e�z, 800 Seminole Road
J A 's Atlantic Beach, Florida 32233
s --- ti FILE COP'! Telephone(904)247 5800
47; FAX(904)247-5845�J13 ��
REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: II- / Z —/7 Received by: Resubmitted:
Permit Number: 17- RA A ik— 3 Spy
Original Plans Examiner: Project Name: 7,,,, ,..k
Project Address: Z (ego ;,.a.,q i U,) .s 5.,,w,
Contractor: Seet-e-Pd\ `E,,Aer5, t. Contact Name: ��.i_k7�1.�6 .,;:
Co ct Phone : 11 o4-6,L(.-0z-`l a' Contact e-mail: c0.k\,.6 ,a c‘r.;1,e_.•."
evision/Plan Check/Permit Fee (s) Due: $ 50, DO
Descri tion of Pro•osed Revision to Existii,_ 'ermit:
ARIMEMIralgElliVC-*k 1 1 1 .LAMINIMPIMenip
IIIMIIMMINIMEW
__r L ' 20101
Additional Increase in Building Value: $w.k - or10,,.,A q,,,,,,A- Additional S.F. --
Site Plan Revised: N 4 z . Public W/U Approval:
By signing below. I (print name) ....i_L I ,....ls affirm that the above revision
is inclusio o the propo es c la ges.
Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
/� A I Office Use Only
Date: -I ' / /'( 7 Approved: x Rejected: Notified by:
Plan Review CComments:
C-64 la c a- C 1-o fp i cl - vp a c COPY o 4' 4-Ars Rev;JQ
,vn sAele-i:
Paw Poe- , -n 91al/ Tor) /n V',L�vc&,o 4/ 110,11 �e on s: -�a>'
/414 Ii; spec/767) (9 - --A-e s-e a/one ./11d•-
Department review required YeNo
Building /11)• •
Planningoning
Tree Administrator Plans Examiner
Public Works
!,—1 ., / ,7
Public Utilities 7
Public Safety
Fire Services
Date Created 4/13/16 Rev.3