2 BENTLEY ST - BPA-08-188 - GUTTERS & SOFFITS REPLACED -` EImOF
PUBLIC PROPERTY
DEPARTMENT I
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APPLICATION FOR THE REPAIR. RENOVATI N CONSTRUCTION
D&MOLITION, OR CHANGE OF USL OR OCCUPAN CIV FOR ANY EXISTING
STRUCTURE OR BUILDpf
1.0 SITE INFORMATION
Location Name: Buikting:
-- -- Property Address -- -- - - -- - —-
1 2-
Property Is IocafW In a:Conservation Area YIN Hl doft Mirk*YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
L
3.0 COMPLETE THIS SECTION FOR WORK IN EX]torlea
UILDINGS ONLY
Addition Existing
Renovation Number of Renovated
Change in Use New
Demolition Existing
Approximate year of Area per flooRenovated
construction or renovation
of existing building New
r
f Description of Proposed Work:
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----- ---Mail Permit to: h1k --
What is the Current use of the Building?
Material of Building? If dwelling,how many units? -
WiU the Builang Conform to Law? Asbestos?
Architect's Name
Address and Phone t )
Mectuv+b's Name
Address and Phone
constrwtion Supervises License ar `1`JJ HIC Registration S
Estimated Cost g)��P,o'leed i Z 00 0 permit Fee CaleulsUon
Permit Fee f�'�d- � Estimated Cost X$71S1000 Residential
EstimatedCostXsil/il000Commwcw---- - - -
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 bui the abov
specifications. Signed under penally of perjury
Date n �U D
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