0035 WILLSON STREET - BPA 04-349 SIDING v
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'A*fLROV€D BY T+IE
R lai `.P.EI1T BE11dG GRANTED
" ! r IT1 OF S BEM
3y
T` Date
Np, i l
Ward
I \ 1 Y Zoning District
Is?Rroperty Located in Location of q p
th®Hlyf'Otie Dwrict? Yes_No ✓ Building 3 S IN r Gf�1 e n
�e;;Rroparty.Located In
tha co,nsomation Area? Yes No LL
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Sidin Construct Deck, Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name
Address & Phone 3s ( 21-76 7 V - 734s
Architect's Name
Address & Phone pp )
Mechanics Name 4 I
Address & Phone 7 y - S 58
What Is the purpose of building?
Material of building?^ 14A f a dwelling, for how many families? /
Will building conform to law? Asbestos?
Estimated cost D 00,0 city License# 3 State License # n d o R-4 s
�¢ Brae Improvmmut (}�
U Lic. 1 10010-7 4
Signature of Applicant
SIGNED UNDER THE PENALTY
OF'PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: /�o vi �/� /� ))Z • 61 ci 7 0
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