49Dudley.Revision 9-14-20 RES20-0172 .CoverSheet 1 of 5_1Revision Request/Correction to Comments
City of Atlantic Beach Building Department
�r?
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Revision to Issued Permit
Project Address: _
OR
I* Corrections to Comments
"ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT M eesaV' 017.E
Date: q.111 lzaz-
Contractor/Contact Name:
Contact Phone:
Description of Proposed Revision / Corrections:
0 self
.( k
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:TV
)
• ill proposed revision/corrections add additional increase in building value to original submittal?
ILJ 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
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Reviewed By
Date
0
Updated 10/17/18