343 Plaza RERF21-0181 Discovered Damage Revision f.-- Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED 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#: ►1 O! -0`
0 7Revision to Issued Permit OR ❑ Corrections to Comments Date: "'"j
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Project Address: v`t' \k 1 Z (i1� $
Contractor/Contact Name: 0\0 V\ Nii L.c7
Contact Phone: °IN'`,S a (O,)-(att, Email: VA"\al 0LO4 i Q V�f® cai c tot
Description of Proposed Revision/Corrections:
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17\ 1\, cLi t_A NJ6 affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• W}f proposed revision/corrections add additional square footage to original submittal?
Ai No ❑ Yes (additional s.f.to be added: )
• s F ,roposevision/corrections add additional increase in bu Iding value to original submittal?
Li No L *Yes (additional increase in building value:$ '•'2_• Q • 0 (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent: U,A, If
(Office Use Only)
..Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
Building -1..-- -k
Planning&Zoning ('� Reviewed By
Tree Administrator `�,S`V D r ¢,
Public Works �V le` /2S
Public Utilities �p I �v Z`
Public Safety ,es,it 1i Date
Fire Services ON1 S' Updated 10/17/18
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