11 BERRYWOOD LN - BPA-2007-912 WINDOWS What is the current use of the Building?
Cs•t�en�cL�
Material of Building? l ' .o If dwelling.how many units?
win the Building Conform to Law? ` PT_ Asbestos?
Architect's Name
Address and Phone ( )
Mechanic's Name
Addrese and Phone t t l o
Construction Supervisors License 0 HIC Registration#— —
Estimated Cost of Projsd: Ca(� Partnft Fee C"Wilion
Permit Fee$4&� Estimate Cost X$71$1000 Residential
_.- _ _ _ __ Estimated Cost X$111$1000 Commercial-----...---An Additional$5.00 b 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
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PUBLIC 130 WwuWc. W b�M=0 '
�JMk.MA%AaHLSllIS 01970
Th:VWUS-MS•FAx 976740.96"
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: Building:
Property is located in a;Conservation Ares Y/N Historic Oftl t YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name: F
Address:
Telephone: _
3.0 COMPLETE THIS SECTION FOR WORK IN ECISIINVNew
Addition
Renovation Number of Stories
Change in Use
Demolition
Approximate year of Area per floor (sf)
construction or renovation
of existing building
Brief Description of Proposed Work:
0Los
Mail Permit to: LA (:c a nWo `��i� off( 2�S�eC, 1-�c� 0� (067