1637 BEACH AVE - REVISION y `1 REVISION CITY OF ATLANTIC BEACH
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800 Seminole Road
A f BP# 16-12f11- ?go/ Atlantic Beach, Florida 32233
r S) DATE / /, 33 / �+(� one(904)247-5800
SIGNED OFFICE y" AX (904)247-5845
61319? REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: /-/7- /7 Received by: Resubmitted:
Permit Number: I Co --RiartR - ..t
Original Plans Examiner: /(03'7 Project Name: Ts r �e A's/el
Project Address: _// R.• - r,i4 4✓+�
Contractor: S'�l�,Ars 4.41.4dsrevall•.4, ,Cve Contact Name: re// c.
Contact Phone : Svr- i/8•7 Contact e-mail: Darr4+I)/ L.rA's.✓744 .,.re74
Revision/Plan Check/Permit Fee (s) Due: $ SD,pp
Description of Proposed Revision to Existing Permit:
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/C/ ///4-'•2 AZ /a 4'7 p? Z .- x
1
Additional Increase in Building Value: $ •0•0'. Addition4, S. JAN 1 A 2017
Site Plan Revised: Public W/U Approval;it
By signing below. I (print name) � ,relt/ a. 5-/.„/74 affirm that the above revision
is inclu ' e of the proposed changes.
Arey el, ______ /- /7-
Signature
-- /7-Signature of Contractor/Agent(contractor must sign if increase in valuation) Date
Office Use Only
Date:/—a 3 Approved: Rejected: Notified by:
Plan Review Comments:
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Department
e2Department review required Ye No
(—Building
Planning &Zoning Plans Examiner
Tree Administrator
Public Works 2 7
Public Utilities
Public Safety
Date Created 4/13/16 Rev.3
Fire Services