1545 Francis Ave 16-RAAR-713 OFFICE COPY
--ALL INFORMATION
Revision Request/Correction to Comments HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 -7t
Phone: (904) 247-5826 Email: Building-Dept2coab-Lis PERMITM
Date: 4 / Z�4:
EIRevision to Issued Permit OR 13--c.rreCtions to Comments
Project Address: J '- F- f-c:L n Q i, IA2-E�
- I 5G -3
Contractor/Contact Name: L) C,
Contact Phone:--zs Email:
Description of Pro osed Revision/Corrections:
k 0-�u jr- C__s
affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional squarefootage to original submittal?
ONo 11 Yes(additionals.f.to be added: I
• Will proposed revision/corrections add additional Increase in buildingvalueto original submittal?
0No 0-Yes(additional increase in building value:$ (ContmaormuqslgngincreawinvaluMionI
*Signature of Contractor/Agent:
(Office Use Only)
X"Approved El Denied F1 Not Applicable to Department Permit Fee Due
Revision/Plan Review Commen
Department Review Required: YP51-
V Reviewed By
t--—plamning&Zoning
Tree Administrator
PublicWorks
Public Utilities
Public Safety Date UPdated 10/17118
Fire Services
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