1661 E Park Ter FNCE20-0141 Revision Submittal Revision Request/Correction to Comments "ALL INFORMATION
r— HIGHLIGHTED IN
%r�
.°` City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
F''u;:' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Fike, ZO - 0I44 I
❑ Revision to Issued Permit OR ❑ Corrections to Comments Date: 2 7i
Project Address: 1.(o I 1. 'PA21.<K 11 Z.
Contractor/Contact Name: eo A}5-7- IV ` fi Vis- --►C L r
Contact Phone: "i c)or r) 5-5-
Email: C rU C EL '-'C d € 6-1 AP ft- , L.?)----N
Description of Proposed Revision/Corrections:
12 AP— LINA 14 of,I Pg,OPe(2- Lt ,, )E, r LC-A7-T- Ski , , N A-t) NC16H )' --
Q v'i,s '( p.) CahAlz,z� k-- -rr—t—
I affirm the revision/correction to comments is i I'sivFogtl4?rgRgled anges.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
❑No ❑ Yes(additional s.f.to be added: )
• W. I 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 L_
_i 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
Permission to Build
V 1 4 /-1/�/4,1V'!_ / give permission to Ana 4-) G"'d(1 )'6171r1 to
build 5tki.) -{ efvveL on my property at
\\00\ lq)V1 Q T-Qivlwct L 0.-1. b t✓k.
______:) ,„271/1 jc472.._
ijilrHomeowner Signature
i 0. ,Notary Signature
�op ro, Notary Public State of Florida ..
Roberta D Carlisle
It 1 My Commission GG 251658
otA Expires 09/15/2022