1291 BEACH AVE REVISION BEAM CITY OF ATLANTIC BEACH
2019 800 Seminole Road
r' Atlantic Beach,Florida 32233
REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS
Date - Revision to Issued Permit I/Corrections to Comments_ Permit
Project Address ! 2 C�
Contractor/Contact Name if S �D►1 T- ►1 L A f l V+k
Phone S �(S " �TO Email �� r Lr 131
Description of Proposed Revision /Corrections: Permit Fee Due$ �•��
Y�AV\-� ✓— 'Rai Cc LQ t'-1 � ,
Additional Increase in Building Value$ Additional S.F.
By signing below,I l`c'tA- l ffirm the Revision is inclusive of the proposed changes.
(printed name) 1 c
Si a ontract (ent-(1@Wac%4 must sign if increase in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
Revision/Plan Review Comments ?oc �zi oIZ k-u p 7t o Copy �Qe i vy n
Dent Review Required:
Building
tinning & Zoning eviewed By
Tree Administrator
Public Works
0
Public Utilities
Public Safety Date
Fire Services