505 Beach Ave DWAY21-0010 Revision Submittal 3.18 .ALl
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Revision Request/Correction to Comments ==ALL INFORMATION
HIGHLIGHTEDIS,' City of Atlantic Beach Building Department GRAY REQUIREDIN .\' ') 800 Seminole Rd, Atlantic Beach, FL 32233
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11.°11' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: D 1od A- al - 0010
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ElRevision to Issued Permit OR ®Corrections to Com .is ate: 41 , .I
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Project Address: ;�0 5 IQg & t'�e Qi 1 1
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Contractor/Contact Name: N l Ivt€, S� [ 1 c...
Contact Phone: ON) dam?— 04,6\1 Email: RA ki1Q-SQbact.k 1e.(2.t241Q1\rOu1'e . to
Description of Proposed Revision/Corrections: Rd lie-r .I VI kW '1A RA p-,tD VX 0 1 10/
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I 1\k14otlo_ SP'I r I 1 affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name) .1
• Will proposed revision/corrections add additional square footage to original submittal? jJ1 1�
®No J Yes(additional s.f.to be added: p� , 0
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• 'll proposed revision/corrections add additional increase in buildin value to original submlittaW I'1 QUA}
No oseEJ'"Yes(additional increase in b ilding v lue:$ )(Contractor must sign rf increase in valuation)
Signature of Contractor/Agent: di. c),L3a
(Office Use Only)
❑ Approved ❑ 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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