1 ABORN ST - BPA-08-31 REMODEL KITCHEN Fes._ --C C�a
PUBLIC PROPERTY
'0' DEPARTNIEI�IT
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MAYOR 130 WAu*NGTnH Sn1F&T•SALAmk%A'ssAcHL5j..ns01970
1V:974745-MS•FA7t M740.9"&
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUP NCY FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building;
------ - - Address--- A g�n=�✓5�--
Property Is boated in a;Conservation Area YM Historic District Y/N
2.0 OWNERSHIP INFORMATION
4.1 Owner of Land
Name:
Address: l A 3.a-r,/ Sr. Sr"fes"
Telephone: `7-7 8r '7 I/-/ zg
3.0 COMPLETE THIS SECTION FOR WORK IN EXI$I1NQ BUILDINGS ONLY
Addition Existing 2-
Renovation Number of Stories Renovated
Change in Use Now
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Hdd Description of Proposed Work:
- /
— ------ ---Mail Permit to: A/- /7 aF 7 - - - --
What is the current use of the Building?
Material of Building? WC7�-C--> If dwelling,how many units?
Conform to law
Asbestos?
wig the Building Con �
Architeds Name
Address and Phone l )
Mechanic's Name
cJ �vX' �2.2._ 1•✓6..1h/�^,f hen O 15��f-� 2.,
Address and Phone O q dq 1 HIC Registration# s6 S
Conswction Supervisors License#
Estimated Cost of Projed Per"Fee Cal Won
Permit Fee$ 1-7 5
Estimated Cost X$71$1000 Residential
Estimated Cost X$41!$1000 Comrnercial----- -- - - —
�� An Additional$5.00 is added as an
Administrative charge.
3
Make sure that all fields aro property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a BuildingPermit to build to the above s
specifications. Signed under penalty of pedury Building;
Date
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