1841 SELVA GRAND DR - REVISION 7/10/17 (
BEACH
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JUL - 7 2011liY OF ATLANTI1300 SeminoleRoad' - � ' ,, X1Atlantic Beach, Florida 32233
r J 1 Telephone(904)247-5800
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REVISION REQUEST SHEET OR
CORRECTIONS 1f0 REVIEW COMMENT
•
7(i 0/i 7 Received by: Resubmitted:
Permit Number: 1ES- 11 -00-(0
Original Plans Examiner: _ Project Name: L oGk1Q•c
Project Address: I$'9 I SQ,\J c aha-
Contractor:RQ\\y W.,...4.A. ,z0;>\ e'Ll ('ontact Name\ '11 0‘``AA.\A-`f
(Cunt 'hone : `71a7-X37-x"10.0 ('contact e-mail:1,,,,A.1'��0yvy_ tjee.k xr►Ao'N
iller: Plan ( fleck Permit Fee is.) I)uc: S 5'0.0C)
Description of Proposed Revision to Fxistina Permit:
P4(- N.:mob" G?
c4- vs,•,. \,0-..% FL 14- !t )4(n • t
Additional Increase in Building Value: $ 3 C (O Additional S.F.
Site Plan Revised: Public \V/ U Approval:_—
fly si,,I1iI below. I (print naw) �0.Y�b �%\NN0.r.. allirm that the above revision
i. in 'Iu.ire of'the proposed chait_e..
7-r-/7
it',na lire of Contractor% Agent .l.untric101 must,t vu it niciratc III Fahn it u'u1 Rile
( Ilia I'+c t)n1t
t);tt: •• t I. . . Appro..'.' X !:r•r.h-l tv.tIlied by.
Plan Review Com nents:
_Gort1act tor) /yas fai Gk 'To to copy vil
pay Roo sTVP r--74,-e.
Department review required Yes X.o
utiding I .
Planning&Zoning
Plan, I.\a ncr
Tree Administrator
•
Punk;Works 0 1
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L Public Utilities .
1 Public Safety I);ii.,
Fire Services
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