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645 Mayport Rd FNCE19-0126 Replacement [-_, ,._ _ _, ar-„,,,,\ FENCE WALL OR BARRIER PERMIT PERMIT NUMBER r FNCE19-0126 oCITY OF ATLANTIC BEACH ISSUED: 11/7/2019 800 SEMINOLE ROAD J `.0;119~ ATLANTIC BEACH. FL 32233 EXPIRES: 5/5/2020 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and there may be additional permits required from other governmental entities such as water management districts, state agencies,or federal agencies. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 645 MAYPORT RD 01 FENCE WALL OR BARRIER FENCE replace existing fence $2800.00 TYPE OF iREAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171797 0000 ATLANTIC BEACH VILLA # 02 COMPANY: ADDRESS: CITY: STATE: ZIP: MASTER BUILDING CONTRACTORS, LLC 484 Whiting Lane Atlantic Beach FL 32233 OWNER: ADDRESS: I CITY: STATE: ZIP: BRENT INTERNATIONAL C/O AMERICAN MANAGEMENT ATLANTIC BEACH FL 32233 INC GROUP WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. Issued Date: 11/7/2019 1 of 2 % '` SL''r r FENCE WALL OR BARRIER PERMIT PERMIT NUMBER r'-li *t; FNCE19-0126 CITY OF ATLANTIC BEACHOV -1 ISSUED: 11/7/2019 -,./ 800 SEMINOLE ROAD �J'; �r ATLANTIC BEACH. FL 32233 EXPIRES: 5/5/2020 2 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc., Republic Services,Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way. 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 4 PUBLIC WORKS RUNOFF INFORMATIONAL i Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing and debris must be removed from job site by Contractor. 6 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL Notes: Any damage done to infrastructure must be repaired by Contractor. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50 FENCE 455-0000-322-1000 0 $35.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$81.50 Issued Date: 11/7/2019 2 of 2 t..L� City of Atlantic Beach APPLICATION NUMBER z� Building Department (To be assigned by the Building Department.) 3r r i'�' 800 Seminole Road r ) CE 1 zt 0 ,� - Atlantic Beach, Florida 32233-5445 /� _h K7 Phone(904)247-5826 • Fax(904)247-5845 '_::�o,t 9:- E-mail: building-dept@coab.us Date routed: (0I dl I i17 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: C `ts_S--- Kat(0of 4-0. De artment review required Yes No Bain Applicant: IA 4° , Bu_.,' ,Q(rl5 (hto,hri n tng&Zonin /Tree Adminisfrator Project: 1�LO-q-�--Q-- IA f C.Q Public tilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation 0.1N ` St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants iN./ Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. Denied. Not applicable (Circle one.) Comments: BUILDING Cricu1-,- -I'1 n Greg PLANNING&ZONING ' by:‘,"- ---7,4' �%�"c/-Reviewed by: am7 Date: (G -LY—f `I TREE ADMIN. Second Review:Approved as revised. ❑Denied [Not applicable. PUBLIC WORKS Comments: le, �ed PUBLIC UTILITIES - � PUBLIC SAFETY Reviewed by: Date: I �/-7) - p FIRE SERVICES Third Review: nApproved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 t;' ' .: Building Permit Application Updated 10/9/t8 J City of Atlantic Beach Building Department OFFICE COPY **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY ,,o ' IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us �)/ !' /� Job Address: 5 mai PO S(} �/�� �} �..�,� `/ Permit Number: Fi l.ki —1 -- O �A, Legal Description 3�-- \3 \"1-2`3— G -J t��• s r , �• v tt\a VKt+a RE# ll 17Q1"0000 Valuation of Work(Replacement Cost)$ 2800.00 Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition JAlteration 6Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): pitommercial f'Residential • If an existing structure, is a fire sprinkler system installed?: LiYes ' (No • Will tree(s) be removed in association with proposed proiect? ❑Yes(must submit separate Tree Removal Permit) XNo Describe in detail the type of work to be performed: ,,pp \— 0 CO 1 _. i _ \' I/r-e Florida Product Approval#_-_ for multiple products use product approval form Property Owner Information Name_ \S 7— Address (.0(45 por+ G( City = _ e.e.c,h State PL zip 3z2,33 Phone ciO4.2.-41—S3 34 }'Z(g E-Mail 3\Clc) K101-2.Donn pant e.S .GUNr\ Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information /� Name of Company t ar �,A'�( U11.� ►� C.0114 Y 6 Qualifying Agent Vl Soh(ISOr Address3(j _ 'TSUrf1 5+• city Orlando State F Zip Z ) I Office Phone q 04 .4(03. 7B S Job Site Contact Number State Certification/Registration # C i25S33w E-Mail Sioh,Isvrr, 0 �lelidcL .eo t p:w1 aes.covrt Architect Name& Phone# Engineer's Name& Phone# W Workers Compensation Insurer_ W C• O2 7 t -l-Y2) OR Exempt ❑ Expiration Date 7 / lIT �0 Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or insttmattpr p r commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws rura}ir� 1__ construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBINGrl iy p Li; WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS, etc. NOTICE: In addition to the requiresr ynf• o I Q permit,there may be additional restrictions applicable to this property that may be found in the public records of this cdun2 d4d0 0 there may be additional permits required from other governmental entities such as water management districts,state aggr> ico, federal agencies. 0j d C OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliancetriVZ applicable laws regulating construction and zoning. 0 `�, :' w L1. s J � } WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT pa 4 L-1. rx m RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU Pu w ti) w TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A ORNEY BEFORE 5 CC w RECOR NOTICE OF COMMENCEMENT. a tCS (Signatur f Owner or Agent) _nature of Contractor) 7 TA Signed and sworn to (or affirmed) before me this-__day of ' ned and sworn to(or affir ed) before me this_11.day of Oero,2 , iOI9_, by -Ji-F- - d- kid rz_ ,ca,apla by 1Q(\ 6112ilbtrj (Signature of Notary) Si nature of Notary) Irdhaiabah.abalhalhawaNdh.dordime �"" ATHENA FORTENBERRY �.tPar v� a✓��" LISA ABINDER i° B`t. Notary Public-State of Florida -f. .\, NotaryPublic•State of Florida /PersonallyKnown OR ''r-i-L Commission # GG 358994 �PersonallyKnownOR ( ;,;�.• •; � ,�a.,i�,,�, ;:e,4j Commission#GG 271994 ( ]produced Identification .,111 r�.' My Commission Expires Produced Identification , ,, ,P ( ] '?or ti � My omm.Expires Jan 12,2023 � July 25, 2023 Type of Identification: 4 __Bonded thea, Natinn.i Nit ry escn� Type of Identification: , A ALL Revision Request/Correction to Comments **HIGHLI HIGHLIGHTED ON rt'` ����% HIGHLIGHTED IN .� *Ai: "' City of Atlantic Beach Building Department GRAY IS REQUIRED. ''l ■pr 800 Seminole Rd, Atlantic Beach, FL 32233 -P-.0;t9'.- Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 'Flo[.....ei' -O ja Revision to Issued Permit OR ❑ Corrections to Comments Date: Jo 1,2.3I/ Project Address: (r ✓1 ¶ rvf k)P01L1 a-o p-0 4}--1- kg.)1 1 'gaa.5_ Contractor/Contact Name: 59-4"../ VD N 1,1)S"'" /114'iSTr_.9. 40, G c-agin K.- • Contact Phone: .16 11"11A. -- 76`x, Email: 05strf iv_b(/�6' L ic-urnz:coAi)4,(Nt1c,CoLA • Description of Proposed Revision/Corrections: R ip-CA) pr�C-C--- 11-1 f-5 P o sL- rv,.. h/ 1x.) 7.4 c- 5ue2vef I 5E7' ) 3t),►'1 3 0 IV affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • ill proposed revision/corrections add additional square footage to original submittal? 3r, o ❑ Yes (additional s.f.to be added: ) • 4I • •posed revision/corrections add additional increase in building value to original submittal? A No ❑*Yes (additional increase in building value:$ ) (contractor must sign if increase in valuation) *Signature of Contractor/Agent: (Office Use Only) ❑ ApprovedDenied ❑ Not Applicable to Department Permit Fee Due$ i Revision/Plan Review Comments � � =�t� . ..i. - :! 7 r ..Atsi A a 111MallirLL•iY!simm.—• 1- -- Department Department Review Required: (_Building2, Planning&Zoning;• - Reviewed By Tree Administrator Public Works Public Utilities I —1 q Li — ( I Public Safety Date Fire Services Updated 10/17/18 • MAP SHOWING BOUNDARY SURVEY OF LOTS 1, 2, 21 AND 22 BLOCK 4 AS SHOWN ON MAP OF ATLANTIC BEACH VILLA UNIT NO. 2 AS RECORDED IN PLA T BOOK 31 PACES 13 OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CERTIFIED FOR: BRENT INTERNATIONAL INC.; WSTAR CREDIT UNION; COMMONWEALTH LAND 71 TLE INSURANCE CO.: ANSBACHER & ACNNEIDER P.A. •A YZ. f.'. .D16.r,O .`*'70li At K I KCi�'''''rlvL. SARATOGA CIRCLE NORTH ¢l]l, r•lO.um x v,nK r[[vo•lac aur,Z=,KRII®x LOVA.KWA5 OF W,11(LIMN.{UlaµDOO LIILCL SlSACr.lp[x,Y MO 6 ,,C.-nor..as (6400 FOOT RIGHT—CT WAY) 75'69'31'251 Fo 1/2W IP 1165.00' ! ET 14921 (P W ) t J ® h Mi i 1.0' m41412' aFT Jd EARL PER PUT — ry ti I A9iHALTPARXIMC 1-4.7' ❑ O RIld S l(l ;. FD 1/2'IP ;'N S7 %MacP FD 1/2'IP 10, ‘� I1 STTC N69.31'25"II 10.00' SD '5. o 0.3)1 YETAL ; o Ci PEr6 Pti1a�fr1 ~ 2 STORYcava i (v I fI A o' COQUINA N AND 1,130D OIiP1 10 © '� ; v 4�A/t g I. tiabl C�1 O Y D, 4a V2 10 P /tom CO ei }l 01 I •, Pr).— 8 = 1❑A/t ' L - JO'BRL PER PUT 1.. 4 ASPHALT PARKIN: 41.2' k. F0 1/2�IP ..4 'CLING VW ---------) .‘61r31'25-11i 155.00' t Fv1/2'IP SARATOGA CIRCLE SOUTH (60.00 FOOT RICHT CF—WAY) THE PROPERTY SHOW Ht EON APPEARS TO LIE 1M MIN FLOOD HAZARD ZONE X AS SCALED FROM FLOOD INSURANCE RATE MAP 0001 FOR THE CITY OF JACKSONNLLE; FLORIDA, DATED 4-17-89 AND IS SHOW AS A COURTESY ONLY AND DOES NOT CONSTITUTE A CERT7FCA7ION OF SAME. r TRI-STATE LAND SURVEY ORS, INC. 8411 8A YMEADOWS WAY SUITE /2, JACKSONVILLE, FLORIDA 32256 (904) 731—7235 LEGEND BEARINGS BASED ON R/W UNE AS SHOMV. a cote war •war COE 7H1S SURVEY DOES NOT REFLECT LW DETERMINE ONNERSHIP. (WT M1"r°"I14 4m) NOT VALID INTHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL IPPM a riOF A FLORIDA LICENSED SURVEYOR AND MAPPER. A COT.OVOID) THIS SURVEY BASED UPON DESCRIPTION AS FURNISHED, AND NITHOU T $OPOSS Q1T BENEFIT LW A TITLE BINDER/ABSTRACT OF TITLE AND/OR DEED RESEARCH. TOLL. IMAM IQwIC•O4 11C It/TY 11100-a OlY1" 30' LARRY G EDDY, P.L.S. No. 4144 rnrc COW=ATA SCALE: aGi ENN M. :-t.: MEET, P.S M. NO. 5814 f aanoaAr or AA' mit=mammy PAo �� R FIELD MCWK DA 1E 6-18-04 �'.._. R.r'S a,H' SUR VE •' ND MAPPER, 0 OOKSCE SICHATURE DATE 6-23_04 TATE „FLORIDA 921) F.R. 976 PG. 58 MITFP NO U4—LBJR ±.A.Nr.f. City of Atlantic Beach APPLICATION NUMBER JtS r "s�� Building Department (To be assigned by the Building Department.) � 800 Seminolec Road A I / G f /, 01�b (,., Atlantic Beach, Florida 32233-5445 /v (�C..` 4 L Phone(904)247-5826 • Fax(904)247-5845 I \\ ��1i ,�;- E-mail: building-dept@coab.us Date routed: 10I d-t l 1..e, City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: CO`tS- M-0-4„06(4-244. Department review required Yes No Applicant: S4 —tl gLL t i `b `atchIS arming &Zonin Tree dminis rotor I -�-- Project: 1�l;PlQ �tA fk P_Ack -: Public_'.tilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date 0-70 of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation � St.Johns River Water Management District ��� Army Corps of Engineers Division of Hotels and Restaurants n-/ Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. Denied. Not applicable (Circle one.) Comments: BUILDING / PLANNING &ZONING Reviewed by: — , ate: /O` 72'19' TREE ADMIN. Second Review: Approved as revis . ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES . PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. I IDenied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ri``',% City of Atlantic Beach - APPLICATION NUMBER s \ Building Department ECEIVE (To be assigned by the Building Department.) it; 800 Seminole Road. f / ` /� �� 5. �� Atlantic Beach, Florda 32233-5445 Q T 2 2 2019 /" til.. -1 KJ / Phone(9 04) ing-de 247-5826 c Fax(904) 471 4 \ u�t �/ E-mail: building-dept@coab.us Date routed: LI dl t [� City web-site: http://www.coab.usi3Y:__ APPLICATION REVIEW AND TRACKING FORM Property Address: Ca 4.S 1"`44-1_too D- •artment review required Yes No : 'dinj �uS-t-( e�Ut�C�� uc r Applicant: Fannin &Zonin; Tree dminis rator Project: f Lp(.'LLi- til 4 Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants \`/ Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: liApproved. Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING yt4.11 ,�t jay..� Reviewed b L / Date:/e<021-1 TREE ADMIN. Second Review: 'Approved as revised. ❑Denied. I 'Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 PUBLIC WORKS PLAN REVIEW COMMENTS J 9 Date: Application#:fiVG,t / / ` d/Zh, Project Address: / /77 j1 V f v CONDITIONS OF PPROVAL TO PRINT ON PERMIT Check Box to Select All concrete driveway aprons must be 5"thick,4000 psi,with fibermesh from edge of pavement Driveway to the property line. Reinforcing rods or mesh are not allowed in the right-of-way. 0 Apron (Commercial driveways—6" thick). Erosion Full erosion control measures must be installed and approved prior to beginning any earth Control disturbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sediment 0 Control Inspection prior to start of construction. —/ Onsite All runoff must remain on-site during construction. q7' Runoff Post Const. If on-site storage is required, a post construction topographic survey documenting proper TOPO construction will be required. All water runoff must go to retention area and retention overflow 0 Survey must run to street. Pool Pool—Wellpoint(if used) must discharge into vegetated area 10' minimum from street or drainage ❑ Wellpoint feature (swale, structure or lagoon). Roll off container company must be on City approved list(Advanced Disposal, Realco Recycling, Roll off Shapells, Inc., Republic Services, Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk Container Removal,All American Roll Off, WCA Waste Corporation). Container cannot be placed on City ROW. ROW Restoration Full right-of-way restoration, including sod, is required. 4� Utility Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid ❑ Road Cut 10' in each direction from the center of the cut. Repair must be shown on the plans. Construction Provide construction site management plan, including location of silt fence, dumpster, portable ❑ Site Mgmt. toilet. Right-of-Way Permit is required if using right-of-way for construction parking. Runoff All runoff must remain on-site. Cannot raise lot elevation. Document Strongly suggest thorough documentation of impervious areas be recorded. 0 Impervious Slab Slab and driveway to be fully removed. ❑ Driveway Maximum Maximum driveway width within the City right-of-way is 20'. ❑ Driveway Circular Maximum circular driveway width within the City right-of-way is 12'. 0 Driveway Grass Full site to be grassed.TOP ❑ Must provide a topographic (TOPO) survey with water retention for final CO Inspection. ❑ Survey Revision Any plan change must be submitted as a Revision to the Building Department. 0 Fencing All old fencing and debris must be removed from job site by Contractor. Cd Removed Decking All old decking and debris must be removed from job site by Contractor. 0 Removed Infra- Any damage done to infrastructure must be repaired by Contractor. l� structure Revised 2/26/19 .iyLyf \ City of Atlantic Beach APPLICATION NUMBER j3~#' r,r�� Building Department (To be assigned by the Building Department.) r ,. 800 Seminole Road /�. t /i —00 6 �� Atlantic Beach, Florida 32233-5445 C C ""( Phone(904)247-5826 • Fax(904)247-5845 117- E-mail: building-dept@coab.us Date routed: to! \\ l (47 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: (P `C T 14- 0d r e4. De•.rtment review required Yes No p B'din• Applicant: 1A-GLS-V-1( pl.E-i VL(/1J (`� _y . ning &Zonin Tree 'dminis rator Project: 1�1 Q c Utilities_ Public Safety Fire Services Review fee $ Dept Signature r Review or Receipt I (.- Other Agency Review or Permit Required of Permit Verified By Date vu Florida Dept. of Environmental Protection Florida Dept. of Transportation / \ St. Johns River Water Management District _ -� Army Corps of Engineers Division of Hotels and Restaurants -\"/ Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: loved. ElDenied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: /0-0257? TREE ADMIN. Second Review: ❑Approved as revised. ['Denied. / Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES , PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Y11r , Revision Request/Correction to Comments **ALL INFORMATION - ` HIGHLIGHTED IN )• City of Atlantic Beach Building Department GRAY IS REQUIRED. ' _ zl 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: fiV(.-E115-0P. Revision to Issued Permit OR ❑ Corrections to Comments Date: /0 [ )i Project Address: (> 'T Y14 A--i fo n-A---a-O f'9-o j A-p(f c b>=4c-)4 gaa Contractor/Contact Name: 52v.-" �J N,-,)Sa'to 114 Comments G cod I r)ff- • • Contact Phone: 9 6 it'llk j'..----7660 Email: 0 rrorf il.),(,rU '114 C—fO7 Lo (fri_1�S,Coi Description of Proposed Revision/Corrections: R r9(P1-CSD l'-= r ) -1•'H r-S a!-vi. - rP G 5 z-'-T'rizyv.J h/ kki. ) T1-P c S u e vE1 I 5E-Pro) "J b►k/$73 o Y'1-9 affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • ill proposed revision/corrections add additional square footage to original submittal? iridi o ❑ Yes(additional s.f.to be added: ) • 41 8 'posed revision/corrections add additional increase in building value to original submittal? ;6 No ❑*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: ,,/ (Office Use Only) Ir Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments De artment Review Required: Buildin fil ' anning&Zoning , Reviewed By Tree Administrator Public Works Public Utilities l -4?-S- " 19 Public Safety Date Fire Services Updated 10/17/18