371 3RD ST - PERMIT RES18-0183 OFFICE COPY
s` ,. . CITY OF ATLANTIC BEACH
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IC800 Seminole Road
-fi r� Atlantic Beach, Florida 32233
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REVISION REQUEST / CORRECTIONS TO PLAN REVIEW COMMENTS
Date /0//6/01c( Revision to Issued Permit Corrections to Comments Permit# fIL:5 18—°I g 3
Project Address
1/43 7 1 3 " 6Tfl( L
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Contractor/Contact Name ///) 4,,,,,t,),74,1/4, t` P6- t 'I S
Phone qa'- 3/ U- 07q,1 Email eAn c #5 re..:--ac=(AP da , oe),„-.
Description of Proposed Revision/Corrections: Permit Fe: Due $ so,
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Additional Increase in :tit it g ,a ue '. / Additional S.F. ,i(
By signing below,I /P n L /J 67 c r/eN j affirm the Revision is inclusive of the proposed changes.
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Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved )(.-- Denied Not Applicable to Department
Revision/Plan Review Comments 7 /4 C 7 74) (aj cl — L•0? �d n Ss)t KSI c;u
010 CU r.#,1 r 6 pay 4 .
Department Review Required: ��A
L. in :�' r
Planning &Zoning Rev ved By
Tree Administrator
Public Works
Public Utilities /0 — y—/9
Public Safety Date
Fire Services