225 2ND ST - REVISION 10-27-17 01"1 hotCITY OF ATLANTIC BEACH
800 Seminole Road
,,. Atlantic Beach,Florida 32233
Telephone(904)247-5800
,y = FAX(904)247-5845
REVISION REQUEST SHEET OR
V/ CORRECTIONS TO REVIEW COMMENT
Date: ' '/ ?/ /7 Received by: Resubmitted:
Permit Number: AES)7—OI 6q1
Original Plans Examiner: ,r Project Name:
Project Address: 0205 5r anti/`e &ate- Ft- 3 223 3
Contractor: ))14d (iSborn. Contact Name: David 05616'.
Contact Phone : el0q)5560-173-7 • 051,0(4 v:(o(.Grs A7 be,USOv-1 . A-e d
Revision/Plan Check/Permit Fee(s)Du : $ 50,0 0
Description of Proposed Revision to Existing Permit:
IgiNgniet r wall /- 1f, 1 tt,Yt INA S /oar) Rrtrt novo I ✓-e
fr,,eje_ /.#.6 Pr 0-0
Additional Increase in Building Value: $ Additional S.F. t�
Site Plan Revised: Public W/U Approval:
By signing below.I (print name) ])Tt'10f OSwrA- affirm that the above revision
is inclusive of the • t•t sed changes.
..11111131PIII" a�a '7J)—T
Signa • e !. 'o tractor/Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Q
Date: / / J 1-) Approved: X Rejected: Notified by:
Plan Revi w Cgmme ts: [� I /
Co/t teC.T /-i Gly —v p Jo10 Cvpy '1) F€ e.
Department review required Yes/lo
e'ruilding 1/ `-__
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Planning. Zoning
Tree Administrator
Plan xaminer
Public Works
Public Utilities
Public Safety
Date Created 4/13!16 Rev.3
Fire Services