1099 CORNELL LN - REV 7-30-18 ,S r-1\-1ffli
CITY OF ATLANTIC BEACH
r `� 800 Seminole Road
` ;' Atlantic Beach,Florida 32233
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REVISION REQUEST / CORRECTIONS TO PLAN REVIEW COMMENTS
Date 7 JO plRevision to Issued Permit Corrections to Comments_ Permit# RE -pazi- 1
Project Address /a q7 d 0 it)/ e// oC y9-A/ k/lifyG a44, 2. 3 3
Contractor/Contact Name P t/y`d' niii/Cii/4.1 — OCA (\P
Phone &,f4 j .2 ?7 (/0 Email ��►4/z!v 7'dDlr1�Y� v:Z (o% ic '-
Description
of Proposed Revision/Corrections: Permit Fee D '. SO. 0 1.
II 6--s)c)t -r,11, 0e,i, y 1,,,_ _________ il "
14-xiace
Additional Increase in Building/ Value $ 0 Additional S.F.
O V
By signing below,I 1�J `�l el4/1 affirm the Revision is inclusive of the proposed changes.
(printed name)
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S atftire of Contractor/Agent(Contractor must sign if increase in valuation) Dat
(Office Use Only)
Approved )r Denied Not Applicable to Department
Revision/Plan Review Comments COn l..cr C 7' 10 / iZ k - 106 Cup/ Q (PT r-e-C
Department Review Required:
uilding ind'---
•ng & Zoning Reviewed By
Tree Administrator
Public Works /
Public Utilities P-'� l r
Public Safety Date
Fire Services
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