500 CLIPPER SHIP LN DWAY21-0001 revision 1-25-21 Revision Request/Correction to Comments **ALL INFORMATION
S!�J HIGHLIGHTED IN
AKA p, City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 t�� �(�y
''r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: '`--'w` �[ - ( ` G� U
❑ Revision to Issued Permit OR E Corrections to Comments Date: / 2-/
Project Address: 5-00 /PPEL -S -,' L-A)
Contractor/Contact Name: Ul C /)g - 'e4 -r -
Contact Phone: 9W--(7(72-4/4S-1,3 Email: CH-1,--15 Ger` g , •C0)/V1
Description of Proposed Revision/Corrections:
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30.0 2..t a a i--/4 GC.- "Ca APPR_ay.
I L'i/12-4Si/t{t L G 241-11affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
jtiNo ❑ Yes (additional s.f.to be added:
• Will proposed revision/corrections add additional increase in building value to original submittal?
ANo ❑*yes (additional increase in building valu . A ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
❑ Approved ❑ Denied LI 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
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•. 30" Wide Concrete Strips
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