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92 DERBY STREET - BUILDING JACKET 92 DERBY STREET Certificate No: 112-07 Building Permit No.: 112-07 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0092 DERBY STREET in the CITY OF SALEM -- - -- - - - ----------------------------------- ---- Aotlress Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY UNIT#1 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires ......................................... unless sooner suspended oirevoked. Expiration Date l Issued On: Tue Apr 10,2007 ------------------ - ---------------- - - _.....__. ._.................._ GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. ----------------- ------ -------------------- -- --- I .;g�4CQ •M. IiMiK �� W 5 / � ` � �� q��' �' �c Certificate No: 112-07 Building Permit No.: 112-07 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0092 DERBY STREET in the CITY OF SALEM --- -- - ----------------------- - ... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY UNIT#2 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires unless sooner suspended or revoked. Expiration Date Issued On: True Apr 10,2007 - -_ - ------------- - - - - - GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. ----------------------- --- -------------------- '� 7 t Certificate No: 112-07 Building Permit No.: 112-07 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0092 DERBY STREET in the CITY OF SALEM ----------------- -- - - ------------....._.. Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY UNIT#3 This permit is granted in conformity with the Statutes and ordinances relating thereto.and expires ` unless sooner suspended or revoked. ------------------------ Expiration Date -------------------_.-- .- Issued On: Tue Apr 10,2007 GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. --- ------------------------------------------------------------ •c,�,4t' ,, .� 3 �► F `� �c,�. oC'�'` a c5� T ►� ��c�� y V30VE AO CITY OF SALEM r BUILDING PERMIT 0092 DERBY STREET 112-07 GIS,#: 16158 COMMONWEALTH OF MASSACHUSETTS Map: 41 Block: CITY OF SALEM Lot: 0063 Category:, REPAIR/REPLACE Permit# 112-07 BUILDING PERMIT Project# JS-2007-0194 Est.Cost: $50,000:00 Fee Charged: . $580.00 Balance Due: $.00 PERMISSION IS HEREBY GRANTED TO: Const:Class: Contractor. License: Use Group; D.Chase Construction Corp STATE-CS 075237 Lot Size(sq::ft.): 4750 Zoning: B1 Owner: PASKOWSKI JOHN Units Gained: Applicant: D.Chase Construction Corp Units Lost:, AT. 0092 DERBY STREET Dig Safe#: ISSUED ON: 18-Aug-2006 AMENDED ON. EXPIRES ON. 18-Dec-2006 TO PERFORM THE FOLLOWING WORK: RENNOVATIONS&ADDITIONS PER BOA POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Building Undergr Underground: Underground: Excavation: Ser ce•� Meter: �� Footings: A og Y1014 rid Rou h: / ��Roug / / Rough: .2MrI43✓•Y lir IT f Foundation: 2 ag g 7/1y� GIS` ; vrt .�Ses�i�/c%y QI tl'1/00 Fini5 Final: a Final: Rough Frame: 6P.� 1 l_1 Ck. asr c�� (90 *- " FireHealth InsMeter: Oil: /e/�47 FinrLHouse# Smoke: C./'•*�� 7 / TreWater: Alarm: / «1--- Sewer: Sprinklers: OES THIS PERMIT MAY BE REVOKED BY T14E CITY OF SALEM U ON YIOLATIO1V OF OV S RULES AND REGULATIONS. ,,,,q /. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2007-000247 18-Aug-06 623 $580.00 Upon completion O! ':;'4 745-8595 E.A. 385 GeoTMS®2006 Des Lauriers Municipal Solutions,Inc. , 0 CITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT •��IINB 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380 MAYOR FAX: 978-740-9846 June 16, 2004 John Paskowski 16 Chester Street Danvers, Ma. Ot923 RE: 92 Derby Street Dear Mr. Paskowski: This Department has received a complaint from a tenant in your building. They are the following: 1. Smoke detectors not working in front hall —None present rear hall 2. Front door on 3`d floor unit is hollow core without deadbolt (Solid core door— 1 hour rating required when replaced) 3. No sheetrock and exposed wiring in rear hallway. 4. Window in front hall to third floor unit is not a rated fire assembly. You are directed to contact this office within 10 days upon receipt of this letter to discuss the repairs. Failure to reply will result in a complaint being filed in Salem District Court. Thank you in advance for your anticipated cooperation. Sincerely, Thomas St. Pierre Acting Building Commission cc: Kate Sullivan, Mayors Office Fire Prevention Electrical Department Councillor Corchado CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE Jurisdiction Hist. Comm. Yes ❑ No REFERRAL FORM Cons. Comm. Yes 0 No SRA Yes ❑ No ❑ Date: % lg f- Address: 9,)— ( � Complaint: / /PTa �1,00<9 (17� y .� loirr°�2, Complainant: Phone#: Address of Complainant: UILDINGINSPECTOR ,FIRE PREVENTION ELECTRICAL DEPARTMENT HEALTH DEPARTMENT CITY SOLICITOR ANIMAL CONTROL SALEM HOUSING AUTHORITY PLANNING DEPARTMENT POLICE DEPARTMENT TREASURER/COLLECTOR ASSESSOR WARD COUNCILLOR DPW SHADE TREE PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO THE SAL PLANNING= WIITpHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE. ACTION:_ —�.-P�� A CITY OF SALEM9 MASSACHUSETTS a PUBLIC PROPERTY DEPARTMENT i��MlN6 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 STANLEY J. LI$DV1CZ, JR. TELEPHONE: 978-745 EXT. 380 �j��®P MAYOR FAX: 978-740-984-984 6 �t/\�2_/�' Q�f' June 16, 2004 �tJ�/ John Paskowski 16 Chester Street Danvers, Ma. 01923 RE: 92 Derby Street Dear Mr. Paskowski: This Department has received a complaint from a tenant in your building. They are the following: 1. Smoke detectors not working in front hall —None present rear hall 2. Front door on 3`d floor unit is hollow core without deadbolt (Solid core door— I hour rating required when replaced) 3. No sheetrock and exposed wiring in rear hallway. 4. Window in front hall to third floor unit is not a rated fire assembly. You are directed to contact this office within 10 days upon receipt of this letter to discuss the repairs. Failure to reply will result in a complaint being filed in Salem District Court. Thank you in advance for your anticipated cooperation. Sincerely, Thomas St. Pierre Acting Building Commission cc: Kate Sullivan, Mayors Office Fire Prevention Electrical Department Councillor Corchado I ONDIT,(AA CITY OF SALEM, MASSACHUSETTS CITY OF SALEM. MA BOARD OF APPEAL CLERK'S OFFICE n ' 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 TELEPHONE: 978-745-9595 FAX: 978-740-9846 2006. AUG - KIMBERLEY DRISCOLL - Q A. 8• Z� MAYOR DECISION OF THE PETITION OF 92 DERBY STREET TRUST REQUESTING A SPECIAL PERMIT FOR THE PROERTY LOCATED AT 92 DERBY STREET B-I A hearing on this petition was held on July 19, 2006 with the following Board Members present:Nina Cohen, Chairman, Richard Dionne, Annie Harris,and Stephen Pinto. Notice of the hearing was sent to abutters and others and notices of the hearing were properly published in the Salem Evening News in accordance with Massachusetts General Laws Chapter 40A. Petitioner request a Special Permit per Section 8-4 to expand an existing non-conforming 3 story structure for the property located at 92 Derby Street located in a B-1 zone. The provision of the Salem Zoning Ordinance which is applicable to this request for a Special Permit is Section 5-3 (2)(8)which provide as follows: Notwithstanding anything to the contrary appearing in this Ordinance, the Board of Appeal may,in accordance with the procedure and conditions set forth in Section 8-6 and 94,grant Special Permits for alterations and reconstruction of nonconforming structures, and for changes, enlargement,extension or expansion,of nonconforming lots, land, structures,and uses,provided however, that such change,extension, enlargement or expansion shall not be substantially more detrimental than the existing nonconforming use to the neighborhood. In more general terms, this Board is, when reviewing Special Permit requests, guided by the rule that a Special Permit request may be granted upon a finding by the Board that the grant of the Special Permit will promote the public health, safety, convenience and welfare for the City's inhabitants. A. Special conditions and circumstances exist which especially affect the land, building or structure involved and which are not generally affecting other lands, buildings or structures in the same district. B. Literal enforcement of the provisions of the Zoning Ordinance would involve substantial hardship, financial or otherwise,to the petitioner. C. Desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent of the district or the purpose of the ordinance. DECISION OF THE PETITION OF 92 DERBY STREET TRUST REQUESTING A SPECIAL PERMIT FOR THE PROPERTY LOCATED AT 92 DERBY STREET B-1 page two The Board of Appeal, after careful consideration of the evidence presented, and after viewing the plans, makes the following findings of facts: 1. The petitioner, John Paskowski,Trustee of the 92 Derby Street Trust applied for a Special Permit pursuant to Section 84 of the City of Salem Zoning By-Law to expand his existing non-conforming residential structure located at 92 Derby Street. 2. The Petitioner was represented before the Board by his Architect,Michael Lutrzykowski,of H.H. Morant Co, Inc. Architects. 3. Specifically,the Petitioner seeks to expand the existing third floor unit to the locus by the dimensions of 13'-6"x 33'-6"over the existing building foot print at the rear of the building. 4. The addition will permit the Petitioner to create additional living space and improve the existing third floor egress. 5. The new deck shall be within the perimeter of the first and second floor existing decks. 6. One neighbor came to ask question but did not oppose the project. 7. The requested special permit may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent and purpose of this ordinance. On the basis of the above findings of fact,and on the evidence presented at the hearing,the Board of Appeal concludes as follows: 1. Literal enforcement of the provisions of the ordinance would involve substantial hardship on the petitioner. 2. The relief requested can be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent of the district or the purpose of the ordinance. 3. The Special Permit granted can be granted in harmony with the neighborhood and will promote the public health, safety, convenience and welfare of the City's inhabitants. 4. Special conditions exist which especially affect the subject property, but not the district in general. DECISIONOF THE PETITION OF 92 DERBY STREET TRUST REQUESTING A SPECIAL PERMIT FOR THE PROPERTY DATED AT 92 DERBY STREET B-1 Page three On the basis of the above findings of fact,the Zoning Board of Appeal voted 5 in favor and 0 in opposition to grant the Special Permit requested,subject to the following conditions. 1. Petitioner shall comply with all city and state statues, code ordinances and regulations. 2. All requirements of the Salem Fire Department relative to smoke and fire safety shall be strictly adhered to. 3. All construction shall be done as per the plans and dimensions submitted and approved by the Building Commissioner. 4. Petitioner shall obtain a building permit prior to beginning any construction. 5. Petitioner shall obtain a Certificate of Occupancy. 6. Petitioner shall obtain proper street numbering from the City of Salem Assessors Office and shall display said number to be visible from the street. 7. Petitioner shall obtain approval from any City Board or Commission having jurisdiction,but not limited to the Planning Board. 8. Unless this decision expressly provides otherwise, any zoning relief granted does not authorize Petitioner to demolish or deconstruct any structure(s)on the property to an extent greater than 50%of the structure as measured by floor area or replacement cost. If a structure on the property is demolished by any means to an extent of more than 50%of its replacement cost or more than 50019 of its floor area at the time of deconstruction,it shall not be reconstructed except in conformity with this Ordinance. Special Permit Granted July 19,2006 Robin Stein l Board of Appeal A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK Appeal from this decision, if any,shall be made pursuant to Section I7,of MGL Chapter 40 A,and shall be filed within 20 days after the date of filing of this decision in the office of the City Clerk. Pursuant to MGL Chapter 40A, Section 11,the Variance or Special Permit granted herein shall not take effect umd a copy of the decision,bearing the certification of the City Clerk that the 20 days have elapsed and no appeal has been filed, or that,if such appeal has been filed,that is has been dismissed or denied is recorded in the South Essex Registry of Deeds and indexed under the name of the owner or record or is recorded and noted on the owner's Certificate of Title. Board of Appeal 3 ar' vi: 1 00 978-531-8653 Hope St.Jean PAGE 113 i Date: 08/1412006 -4:00 PIO. OF PAGE 3 (include this page! To. ! From: Name; Hope St. Jean TEL&FAX: (TEL) 978-531-8053 (FAX) 978-531-8653 E-Mail: Hope@stjeaninsurance.corn Company: Thomas St, Jean Insurance Address: 106 Lynn Street Peabody, MA 01960 f f ( Comment: i I � I I 1 i I ! I 0811412.]06 14:00 97&5:31-8653 Hope St.Jean PAGE 26 r A CC' s CERTIFICATE OF LIABILITY INSURANCE DATE'MMIDD 03/14P20Gi_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Thomas St. Jean Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O Box 3543 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 106 Lynn Street Suite 301 Peabody, MA 01961 INSURERS AFFORDING COVERAGE NAIC N I INSURED American Chimney Sweeps, Inc. INSU„=a A'. NAUTILUS INSURANCE COMPANY _ 17370 - 62 Pulaski St nt,,EFF PILGRIM INS CO __ _ 21750 _ Peabody, MA 01960 INSURER: ST PAUL FIRE&CASUALTY INS CO 40967 I INSURER E'. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING AN, REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MA+PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CGNDITIONS GF SU(L 70-ICES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR iDp'�-'—'...� '— POLICY EFFECTIVE PgLICYEXPIRATION, V j LTR III SR� TYPEOFINSURANCE POLICY NUMBER DATE M @�TE MMIDDIN LIMITS A I GENERAL IABILITY NC 401397 11/30/05 11/30/06CC ° oc_URFEIIH F _ 1,000 000 CCN iEFG1A GEPIERALLIA6'�.I Y -EAM�U F PI � r �(I OOOOO _ CLAIMSMADE ��OG'UR HEE F IArry I song S r Ooc I FE NZLs t IIW162Y ¢ 1 OlOCI 000 I cerIERAL AG,FEGATE — L__2200000 Ud'L AGGPEEATE UNIT APPLIES PET'. PROC�JGTC_COMP;pPFGd S2CQ0000' _ � I POLICY1-1 PECT F-1 LOC. I ' B AUTOMOBILELIABILITY PMC 7158580 04/27/06 04/27/07 ICQ'ABINED'sGrLELIMIT $ 500,0001 t ,AWAUTg (Ea acadwrll ALL OWNED AUTOS DODILY INJI-IF S:HEOLLED AUTOS (FerpaT.>rj X HIREDAUTOS BODILY T VP, X NON.ONMED AUTOS IP'' PF'�EPTi[KIHuGE S (PerrzCcic l) GARAGE LlASILUY IaU-J-Plf-E4 ANYAUTO r HER THPP q0 E."'C I $ EXCESSNMBRELLA LIABILITY L _ I OCGJF' CLAIMSMADE r I A-ISRECATE $ - p $ t I - DSucnELE $ RETErmoN $ �— y YORKERS COMPENSATION AND 7PJUB-'7206B22_3_06 05/06/06 05/06/0/ 1 X -11,IIMi`� `ER i EMPLOYERS'LABILRY --- dvRRLFRIETOR,F'ARTNERIEXECIAVE Ie,_EACHAeaDEr 3 100000 _ PTIICE'-AvEMSER, CLUDED? E ca-Ea<,E.eAehaaLor=e x 100 000 Iyys describe under — --- i 3PFCIAL PROVISIONS below EL DISEASE-POLV:':,JIPP 500 OQD � OTHER I I DESCRIPTION OF OPERATIONS(LOCATIONS I VEHICLES(EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Job Luciaana Staintial 2 Andover Street Salem MA 01970 II '1 C,ER71FICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIFAnON DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL_� DAYS WRITTEN SALEM BUILDING INSPECTOR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$0:'HALL IMPOSE NO OBLIGATION OR LABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE �a I I ACORD 25(2001/08) 4ACORD CORPORATION 1988 08/14/2006 14.00 978-531-8653 Hope St.Jean PAGE 3/3 IMPORTANT l i Ii If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement I on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate j holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. I I I i i I I I , I I I, y l ACORD 2'(2001/08) 4PLlk1SIMST19EffLfBTiN0 APPROVED By T44E .WPFCTD-R,PFMIR TD A PERMIT BEING GRANTED CITY OF SALEM N\\� Date Ward � nnxa°' Zoning District Is Property Located In Location of the Historic District? Yes No_ Building Is Property Located in the Conservation Area? Yes No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, Install Siding, 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: T Owner's Name '/ C9( ✓1 ki T /--) K O C�j Address & PhoneIJV9 PLV (T74Y b'q 7 _ c�Fo 6 Architect's Name Address & Phone I Mechanics Name 7-4 /VO ao-,�� Address & Phone / U Jac '+—/ /2-1-e Law &9 (c 7 �2 2 6'15-� ' What is the purpose of building? ? t,/n,_ Material of building? w oO 4 It a dwelling, for how many families? Will building conform to law? Asbestos? Estimated co t�l('9_ QWWOW r 9 09 state License# 0 2 VP 2Hamue Z /� rovement. aJ/Co � 5 '— Signature of Applicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE N nS, G�w �� Uu".P Pm W i teou7 +, 29-c4 5 41v1197 f MAIL PERMIT TO: ., C.0 �l�n/ P �� 16 (-Ia-j-r -e2 t 01g23 APPLICATION FOR PER%�TO ` L LOCATION o�, PERMIT GRANTED AP P OV�D INSPECTOAL GS ,f ��CONDfT��Q CITY OF SALEM, MASSACHUSETTS a PUBLIC PROPERTY DEPARTMENT 9� ✓' 120 WASHINGTON STREET, 3RD FLOOR 9��/MINE OON SALEM, MASSACHUSETTS 01970 STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380 MAYOR FAX: 978-740-9846 June 16, 2004 John Paskowski 16 Chester Street Danvers, Ma. 01923 RE: 92 Derby Street Deal-Mr. Paskowskl`.- This Department has received a complaint from a tenant in your building. Ll They are the following: 1. Smoke detectors not working in front hall — None present rear hall 2. Front door on 3id floor unit is hollow core without deadbolt (Solid core door— I hour rating required when replaced) No sheetrock and exposed wiring in rear hallway. —. 4. Window in front hall to third floor unit is not a rated fire assembly. You are directed to contact this office within 10 days upon receipt of this letter to discuss the repairs. Failure to reply will result in a cumpluir1 being filed in Salem District Court. Thank you in advance for your anticipated cooperation. Sincerely, Thomas St. Pierre Acting Building Commission cc: Kate Sullivan, Mayors Office Fire Prevention Electrical Department Councillor Corchado — M�±i PUBLIC PROPERTY DEPARTMENT /yam KIMNERI.EY DRISCOLL MAYOR 120 WASHING ON STREET JAtrtr,M,tictncHt;Stl'rs 01970 TEL 978-745-9595♦FAX:978-740-98" APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION DEMOLITION,_ _ OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING STRUCTURE OR BUILDING 1.0 SITE INFORMATION Location Name: q 2tQ c S Building: Property Address: w Property is located in a; Conservation Area Y 1�— Historic Distri Y N 2.0 OWNERSHIP INFORMATION a 2.1 Owner of Land Name: Address: b LG,�S ele- _ v Mw o ; -7z3 Telephone: 4 d' 6 5 - y g 0 6 3.0 COMPLETE THIS SECTION FOR WORK IN EXI[SI 13 BUILDINGS ONLY Addition Existing 3 Renovation Number of Stories Renovated Change in Use New Demolition Existing 3400 — Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New Brief Description of Pro/posefd�Work: As ¢Jess-ta O-s- ) d eQ Mail Permit to: -- -- What is the current use of the Building? Material of Building? If dwelling, how many units? Will the Building Conform to�nnLnnaw? Asbestos? Alh Architect's Name r ` `h Address and Phone Mechanic's Name Address and Phone Construction Supervisors License# OZS237 HIC Registration# Estimated Cost of Project$� Permit Fee Calculation Permit Fee $ J Estimated Cost X$7/$1000 Residential Estimated Cost X$11/$1000 Commercial An Additional$5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury X/ D to � C on ` o ., > u 1