665 Sailfish Dr ACC21-0036 COVER SHEET revision 7-23-21_1Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________
Revision to Issued Permit OR Corrections to Comments ________
Project Address: ____________________________________________________________________________________
Contractor/Contact Name: ____________________________________________________________________________
Contact Phone: ______________________________ Email: _________________________________________________
Description of Proposed Revision / Corrections:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
I_______________________________ 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 increase in building value to original submittal?
No *Yes (additional increase in building value: $____________________) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent: _______________________________________________________
__________________________________________________________________________________________________
(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
ACC21-0036
0 7 /2 2 /2 0 21 Date:
665 Sailfish Drive, Atlantic Beach, FL 32233
Nicole Duarte
(904) 662-3735 jkf35035@yahoo.com
Digitally Certified Structural Plans
Nicole Duarte
4
4
4
Nicole Duarte, Office Administrator for Lucas & Scott Engineering
07/22/2021