9 BARR ST - BPA-08-284 SIDING EY'I'ro—
PUBLIC PROPERTY
DEPARTMENT
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A��>PI.ICAyTIQ M 31Z REPAIR.RENOVATION.CONSTR_EW
DLMVU ION OR C UNG�QF USE OR OCCUPANCY.FOR ANY EXISTRVG
S'I'RUC'T11RY�Q�„ IIVG
1.0 WIV INFORMATION J
Location NWM SuldkV
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Prop"is l=W to s:Conswva"Ares YIN_AL_Histdto 0W t YJN fv .
a OMERSHIP INFORMATION
2.1 Osmer of Land _
Name: wig anon p 'sty
Addre
Telephone: 9 7 - 74 S- O r -t
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e.b401111PL IE.TNIS SECTION FOR WORK IN E](ISZWG BUILDW" ONLY
Addition Existing
Renovation Number of Storles Renovated
Change In Use New
Demolition Exiadrtg
Approximate year of Area per floor(so Renovated
construction or renovation
of existing building NOW
Brill Description of Proposed(IWork:
_---Mail Permit t0: U -- - --
VVt1et is it►s Current use of the Building?
Matww of Building? ls'W If dWeifing,how many links?�--
vvM Me Building COnfarm to Lawn Yes Asbestos?
ArchkSCCs Name
Address and Phone l 1_
MedwMi s's Name
Addrena and Phone ` # I`i Z i 3
Ca"Oucfian gupmvieors Licer"# OG 3G �,_ H�Regl�atlon
56
Estimated CoM�of project S 8 B,cw Permk Fee CaMubtlon
Permit Fee S Estimated Cast X$71$1000 Residential
_..... . ._ EstlmatedCMt.XSf11314WCaWnerdW-=-..__.... _.... ... . . .. .
An Additjonal$5.00 is added an an
AdminislinkWO
Make ours that all fields We Proper and tegklly wridon to ovoid delays in procesdng.
The undersigned does hereby apply for a Building Permit to build to the above stated
sPeofficas" Stgned under penally of POAW n a F 6o-
Date 2ts a�
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