1624 Atlantic Beach Res18-0059 Revision CITY OF ATLANTIC BEACH
800 S
OFFICE COPY Atlantic Beach,Floridal 322233
Q —R�EV�IySION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS C
Date 1 /3 Revision to Issued Permit✓ Corrections to Comments_ Permit
Project Address I Z 7['Kd.f1.-lig
Contractor//Contact Name [ge
Phone to— LL- ogr,s Email
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Description of Proposed Revision/Corrections: Permit Fee Due
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Additional Increase in Building Value$ Additional S.F.
By signing below,I affirm the Revision is inclusive of the proposed changes.
(printed name)
Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved Denied / / Not Applicable to Department
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Revision/Pi Review Comments_CO///120/ A PLa tin ; O h n&� 0_F4.1 �w+—
Department Review Required:
Building
Planning &Zoning Reviewed By
Tree Administrator
Public Works �— t pi
Public Utilities !D
Public Safety Date
Fire Services
REVISION
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DATE_J /
SIGNED_
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