888 Seminole Rd - RESO20-0004 revision sheet 6-11-20_1t u Revision Request/Correction to Comments ALL INFORMATION
HIGHLIGHTED IN
m City of Atlantic Beach Building Department GRAY IS REQUIRED.
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800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
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XRevision to Issued Permit OR Corrections to Comments Date: / i l / 7C-')
Project Address: (.?)87 SC'M (r 01 P , (.C" ,
Contractor/Contact Name: 1---- (15-0.,(4...)CAI F-- C a
Contact Phone: (O l Co—7(07 4 Email: J f Q(,c)c I,./ C om p a n f cAnA0,:i ( „
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Description of Proposed Revision/Corrections:
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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 C Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
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anning&Zoning Reviewed By
Tree Administrator
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lc ti ities
Public Safety Date
Fire Services Updated 10/17/18