14 COLUMBUS AVE - BUILDING PERMIT APP (003) What is the current use of the Building?
'� If dwelling,how many units?
Material of Building?
Will the Building Conform to Law? Ty � ? —
Archited's Name
Address and Phone ( )
Mechanic's Name
Address and Phone
Construction Supervisors License 0 HIC Registration S
Estimated Cost of Project$01) S�V`- Permit Fee Calcubtlon
Permit Fee S 20 cd Estimated Cost X$7151000 Residential
-. ------. .-- - - - -_.__------ . -_ . - Estimated COstX S411i1000 Commercial— -
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 by to the above stated
specifications. Signed under penalty of perjury
Date
J _I
Na
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Pit-
EITrOF
PUBLIC PROPERTY
DEPARTMEINT
XMIEZ"03 SC=
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130 WAsluacncyl S`I1EbT "�y ��1 is 01970
nM.97t-715-9M•FAX M7404M
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUP CY FOR ANY EXISTING
STRUCTM OR WELDING
1.0 SITE INFORMATION
Location Name: Building;
R0P"1•k 0dW in a;ConswMI0n Area YM Hlstarlc Otetrlct YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: 11' a�
Address:
Telephone: 9 -4-Lt
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation �j pJ
of existing building l New
9dd Description of Proposed Work: n
S 1
------- ---Mail Permit to: --