15C FILLMORE RD - BP-07-949 What is the current use of the Building?
if dwelling,how many units4
Material of Building?
Asbestos?
an the Building Conform to Lav imney sys
Arehiterd's Name
Address and Phone
979-977-9900
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration#
Permit Fee Cal Won
Estimated Cost of Project i C
Permit Fee i Estimated Cost X$71$1000 Residential
----- ._-- _ Eatimaw costX ill/S1000 Commercia4—
An Additional$6.00 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 the above stated
specifications. Signed under penally of perjury X
Date
0
y N
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Y
.°o�O V y Y
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PUBLIC PROPERTY
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APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRU _ OR BUILDIN
1.0 SITE INFORMATION
Location Name: /�'� jC Buiiding:
-— Property Address —
Properly is boated in a:Conservation Area YIN A,L.Historic Dislrkt YIN lr )
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name:
Address: l� �M" o �✓'
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EYISXING BUILDINGS ONLY
Addition Existing
Renovation ,Q Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of :Areaper floor (so Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
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The Chimney Guys
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Mail Permit to: 978-977_9900