502 SEVA LAKE CIR RESO21-0036 rev. 6-3-21 Revision Request/Correction to Comments **ALL INFORMATION
'0%NHIGHLIGHTED IN
• City of Atlantic Beach Building Department GRAY IS REQUIRED.
" 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.usPERMIT#: ((e -Z� %��(�:
❑ Revision to Issued Permit OR ❑ Corrections to Comments Date: 6 ` 3 - (9-6-
Project Address: 5Qi �1Lj,4 A4gi: 614-
Contractor/Contact
1/ —Contractor/Contact Name: 4e41._ '"'
Contact Phone: 5 j" Email: Aliwy&p6A-iiØccl /( ` t AJ I
Description of Proposed Revision/Corrections:
4.4f,
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?
❑No ❑ Yes (additional s.f.to be added:
• Will proposed revision/corrections add additional incr-ase in b ding value to original submittal?
❑No ❑*Yes (additional increase in building va / $ I on r. . . sign if increase in valuation)
*Signature of Contractor/Age • A`%re7/4 �I
(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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Selva Lakes Homeowners Association, Inc.
c/o Selva Lakes Homeowners Association, Inc.
P.O. Box 331365
Atlantic Beach, FL 32233
Website: selvalakes.com
Date: April 12, 2021
Project Ref: [82293725] 502 Selva Lakes Cir
Michael & Linda Thibodeau
502 Selva Lakes Circle
Atlantic Beach FL 32233
Dear Michael & Linda Thibodeau,
I am pleased to inform you that the Selva Lakes Homeowners Association, Inc.
Architectural Committee has approved your application for the listed project item(s):
Screen Porch
The approval is contingent upon compliance with the specifications set forth in the approved
application.If your change or addition requires a county,city or state permit, it is the
responsibility of the homeowner to obtain this before starting construction.
Please do not reply to this message. If you have any questions or need to provide additional
information,please e-mail us at arcsla@gmail.com.
Sincerely,
The ARC Committee
i
Selva Lakes HOA
Request for Project Approval
This Request form is to be completed by Homeowner and submitted to the ARC prior to the commencement of work .
THIS SECTION IS TO BE COMPLETED BY THE HOMEOWNER
1 rte.
Name: / 1///J.46-"L rth.ett -zJ Email: 4 /Tii&l/WL11?_- )477 , Mri—
Address: L'4 s- (14,e_• Phone: */ ?6,,.; `:J/-z6;1J
EST.Start Date: 74-51( Ai/2._ _EST Complete Date: 2-41U4/s ,44-A-."_. 57/1--/_7—_
IN THE SPACE BELOW PLEASE DESCRIBE IN COMPLETE DETAIL THE PROPOSED WORK TO BE DONE
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*To expedite the process, please include in the proposal brand, material,design, color,pictures, contractor etc.
* Please note all paint colors must be Benjamin Moore and in a flat sheen
IMPORTANT: Homeowners are responsible for the conduct of the contractor. Homeowners are responsible
and liable for any damage caused to common areas or adjacent properties. When required by the City of
Atlantic Beach, permits are required for work. If required, please submit copy of permit with this request.
Homeowner Signature: ( ,/T -4 "Date: )4f,e__ 0C ' .
Date Received by ARC: ARC Decision Date:
ARC Signature:
ARC Comments: