5A FILLMORE RD - BPA ghat is the current use of the-Bwilding? ► �`�`"`r ' ��
Material of Building? L 6ocQ If dwelling;how many units?
01 the Building OM6f to,Law?.
Asbestos?
Architect's Name
Address arid`Phone _ ( ) .
V\ t- �a
Mechanic's;Name , ^^ D7�t''Z,b
Address and'Phone
Constriction Supervisors Ucsnse#`x HIC.-Registration#
Estimated:Cost CA oL -: PertnS Fee Cakxilatton'
permit Feeri )� — Estimated Cost X=S7/51000 Residential
----- -- — -- - ---- --- ----EstlrraiettGost)Fsft'fS1"0(Ig. --An Additional 55:00?is added'�as�an
Adminisirafve charge:
Make'•sure that all-fields are'properly and legibly writtendo:avoid"delays,in;processing:
The undersigned does hereby apply.for ra Building°Permit to build toahe above'-stated
I
speoftations. Signed under rpenalty oUpenury.
Date
� of
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a A e'
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/ CITY Or , . -
PUBLIC PROPERTY
D -Pt1RT1-itNT
MnvM 130 WA HRNcs W b%n Fh7 S'_s;,M s�at�st�as o1970.
'tt+t976Ti9$93•�F.uC;97d:TilY93�6=
APPLICATION ORTHE.RE REN < YATIOri ,CONSTRUCTION
DEMOLITION. OR C . GE DF USE tOR OCCUPANCY..FOR ANY. EXISTING
STRUCI"tJRE.OR.BUILDING
10 SITE INFOR!U ON
LccationNams:
Properhr
property is loaned'in a;Coiiaervation,AO YM Fllstorlo Dtstrld iFM
2�0 OWNERSHIP INFOR �TION
21 Owner of.Land
Name:
Address: 5�- f; 61Dre PO
-
�GR�ew�l: tAA . ,_OIQ2'o,
3.0' 80LETE T14I8 SECTION'FOR WORK•IN.E�L_ 31QT�N BUILDINGS°ONLY
Addition Existing
Renovation NUmber of Stories Renovated
Change in Use New
Demolition Ex1§ling
Approximates year of Area per fioor.(sf) Renovated
construction'or renovation
of existing building Ne`,w-
grief Description of Proposed Work: Ise r2 {� 11
G�e-S
Mail Permit to: rf-m0ry - 0242 b