443 Skate Rd ACC21-0044 Rev Submittal .L,�iRevision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
V 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: C2 i.— OOL14
0 Revision to Issued Permit OR ❑Corrections to Comments Date: 31 ‘112-
Project
12-Project Address: Hi-k3 S Ree KJ.- piA-1 „4;C se4LAr‘ T L 32.233
Contractor/Contact Name: A4l�Vl�e ( / 1‹r+j,nso,r,
Contact Phone: 1-1(;— q2.5-- 6 (7 J Email: WI Sri nS WI 1-4- (14"'\U /1'.'\41 I
Description of Proposed Revision/Corrections:
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I Midi, ( M 4r I l OS'"\ affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name) ECEIVE
• Wi I proposed revision/corrections add additional square footage to original submittal? AUG 1 1 2021
No I 1 Yes (additional s.f.to be added:
BY:
• ► I proposed revision/corrections add additional increase in building value to original submittal?
o Q*Yes (additional increase in building value: $ )(Contractor must sign if increase in valuation)
*Signature of Contractor/Agent: /�i����
6/ LL
(Office Use Only)
El 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