830 BEACH RFNC21-0100 REV. 8-11-21 Revision Request/Correction to Comments **ALL INFORMATION
- HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
._r" 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: �FMCZI - Q(oo
ElRevision to Issued Permit OR ❑Corrections to Comments Date: 9101 Z. '
Project Address: g3C 16E C
Contractor/Contact Name: 00/i-ST ZO Q0'-T- �`r`.J CC C_e)
Contact Phone: "(/ qQ 77) Email: �' TO G �(% Gl; ��� Vt1 L C--Vv`v
Description of Proposed Revision/Corrections:
S 1 'G- Jo Fr SL^�'(�c�f�
joAd47-11,41J-170-4-611.2 '5-5— 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?
ONo I I Yes (additional s.f.to be added:
• ill proposed revision/corrections add additional increase in building value to original submittal?
LjNo E*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
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LOT '6, CLUB MANOR, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
25, PAGE 62, .DF THE;CURRENT PUBLIC RECORDS OF THE CITY OF JACKSONVILLE, DUVAL
COUNTY, FLORIDA.
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