870 SEMINOLE RD RES21-0030 rev 2-8-21 Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
F A City of Atlantic Beach Building Department GRAY IS REQUIRED.
kli800 Seminole Rd, Atlantic Beach, FL 32233
japY
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: g664/-0030
❑ Revision to Issued Permit OR KI Corrections to Comments Date: a/vAi
Project Address: $7O Sernip..)oi-e 2oAb, ,4Tts�Nnc $EAGN, FL 3aQ33
Contractor/Contact Name: &-4 ioP.+Ee F>uµaIADsS
Contact Phone: yWb .6O3 6775 Email: CNR-I5To'NEg. m. auMotzski Q 6,014,1L. .0„),
Description of Proposed Revision/Corrections:
REMoPE. / )TGHEN, jEMoDEL- LAuA)DQY Rory- , Aob DooRioAr FRoivn K11 M -ro
csttND,eY ROOM
I CNc'STDPNE2 turi01,45k-1 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?
LgNo ❑ Yes (additional s.f.to be added:
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No DA*Yes (additional increase in building value: $ /5'000 ) (Contractor must sign if increase in valuation)
(��L*Signature of Contractor/Agent: 4,4,6 Oak
(Office Use Only)
LI Approved Li Denied ❑ 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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