7 CEDAR AVE - BUILDING INSPECTION (2) Erry"6F
PUBLIC PROPERTY
DEPARTMENT
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�r�Yolt 130 WARUNG M SMM• •M h . LSk-1-Ts 01970
Y4i M745-MS•FAx 9M740.M&
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY
OR B FOR ANY EXISTINGl
STRUCTURE UILDIN .
1.0 SITE INFORMATION
Location New Building:
Property is located in a:Conservation Arms YW Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land I `
Name: ,k. . (::nLnl2
Address:
Telephons:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
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
Bdef Description of Proposed Work:
--- - ---Mail Permit to: M 1 ko
What is the current use of theBuilding? j i
C-(.0 if dwelling.how maMl units?
Material of Building? � L
will the Building Conform to law? C Asbestos?
Architect's Name
Address and Phone ( 1
Mechanids Name
Address and Phone
Constriction Supervisors License 0 HIC Registration#
0 GU a Parma Fee Calculation
Estimated Cost of Project$
Permit Fes$te— Estimated Cost X$7/51000 Residential
Estimated Cost X$11/51000 CommercW -- -An Additional$5.00 is added as an
Administrative charge.
Make sure that all fields are property 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
Date ;
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