1785 BEACH AVE RESO21-0073 revision 9-13-21 Revision Request/Correction to Comments **ALL INFORMATION
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City of Atlantic Beach Building Department GRAY IS REQUIRED.
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800 Seminole Rd, Atlantic Beach, FL 32233
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Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: KE.S CV* 007 3
❑ Revision to Issued Permit OR Corrections to Comments Date: [f 13/2-(
Project Address: / .7 cS Ale C( 4-I V fc-
Contractor/Contact Name: 4044_ G SGS ll5, Gec: •yl//e----Y
Contact Phone: 4 C) 6 5 Z 7 `3 ,k2/-
j- , Email: d 1 es T, (c)( 1k..00 . 6. --1,x---L
Description of Proposed Revision/Corrections:
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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?
Ifa ❑ Yes (additional s.f.to be added: )
• Will pro sed revision/corrections add additional increase in building value to original submittal?
o ❑*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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EXTERIOR IMPROVEMENT
1785 BEACHAVE A1002
ATLANTIC BEACH,FL