695 ATLANTIC BLVD SIGN21-0011 rev 6-7-21 Revision Request/Correction to Comments **ALL INFORMATION
% HIGHLIGHTED IN
cr, City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
477* Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 574,.v 2.1 'co
❑ Revision to Issued Permit OR Corrections to Comments Date: Z/7/ .j
Project Address: CoQ c /4yz •i LV C
Contractor/Contact Name: 'k/iAAA 14 6 C-Ck La4;-cf
Contact Phone: (90 tiPt4 3 r .-Lts-S- Email:
Description of Proposed Revision/Corrections:
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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?
Vo ❑ Yes (additional s.f.to be added:
• Will proposed revision/corrections add additional increase in building value to original submittal?
�lo ❑*Yes (additional increase in building value:$ ) (Contractor must sign if increase in valuation)
a
*Signature of Contractor/Agent: (/I/`'l.2r
(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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