Loading...
365 W 3rd St RES20-0082 3rd submittal 1 of 7 cover sheet_1 Revision Request/Correction to Comments **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________ Revision to Issued Permit OR Corrections to Comments Date: ________________ Project Address: ____________________________________________________________________________________ Contractor/Contact Name: ____________________________________________________________________________ Contact Phone: ______________________________ Email: _________________________________________________ Description of Proposed Revision / Corrections: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ I_______________________________ affirm the revision/correction to comments is inclusive of the proposed changes. (printed name)  Will proposed revision/corrections add additional square footage to original submittal? No Yes (additional s.f. to be added: _____________________________)  Will proposed revision/corrections add additional increase in building value to original submittal? No *Yes (additional increase in building value: $____________________) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: _______________________________________________________ __________________________________________________________________________________________________ (Office Use Only) Approved Denied Not Applicable to Department Permit Fee Due $_______________ Revision/Plan Review Comments_______________________________________________________________________ __________________________________________________________________________________________________ Department Review Required: Building _____________________________________________ Planning & Zoning Reviewed By Tree Administrator Public Works Public Utilities _____________________________________________ Public Safety Date Fire Services Updated 10/17/18 Ashley B. Collins/ Collins Builders Group, LLC Ashley B. Collins/ Collins Builders Group, LLC 4 4 4 DocuSign Envelope ID: 24991D43-C121-44CD-9517-6038A07033BC 7/2/2020