30 BOARDMAN ST - BPA-2007-915 REPAIR FRONT PORCH PUBLIC PROPERTY
DEPARTMENT
KISMOU N MMCULL
MAYOR 130 WAMINa"bY1EEY•SALXK MAAACHLSLr S 01970
I'M;97&74S-9S9S 0 FM 97&740.9U6
APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION.
DEMOLITION OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
ESITEFORMATIOName: Building:
ddress:
S
properly Is located In a;Conservation Area YIN Historic District YIN
2.0 OWNERSHIP INFORMATION
2A Owner of Land _
Name: r✓ �C fit?
Address:
Telephone:.
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation �4- Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work: r�s
L--('ir C i� !?Ej25 i—�Nfl ti1G `Y �`iPciA2� ��talCC,f)
---- -- -- - Mail Permit to: F=—:L-L- r- t k-c
What is the current use of the Building?
Material of Building? 1,0wr If dwelling, how many units?
Will the Building Conform to Law? Asbestos?
Architeas Name
Address and Phone
Mechanic's Name 1'—C
Address and Phone
Construction Supervisors License# i HIC Registration#_�
Estimated Cost of froj S ') Permit Fee Calculation
Permit Fee$= Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/i1000 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
Date
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