8A GABLES CIR - BUILDING INSPECTION F � es -� ce✓ s;hq�e ��^, y
What is the current use of the Building?
Material of Building? W boa If dwelling,how many units? —
Will the Building Conform to Law?
eS Asbestos?
Architect's Name
Address and Phone
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration# —
Estimated Cost of Project S
®O Permit Fee COMM
Permit Fee i 25 Estimated Cost X$71111000 Residential
- Estimated Cost X S11/111000 Commercial------
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 to the above stated
specifications. Signed under penally of perjury
Date 6
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PUBLIC PROPERTY
DEPARTNIENT �/
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TeL 9711-74SAS95♦FAx,974.740-96"
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCI AWY FOR ANY EXISTING
STRUCTL U OR BUILDING
1.0 SITE INFORMATION "
Location Name: Building:
Property Address:--- ------ - - - - -
$ b
Properly Is located in a;Conservation Area YIN Historic Oftlot YM At
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISIINQ BUILDINGMONLY
Addition ExistingRenovation Number of Stories RenovatChange in Use NewDemolition ExistingApproximate year of ( Area per floor (sf) Renovate
construction or renovation 0
of existing building New
Bdef Description of Proposed Work:
\\ / V I>C ) 3' 6 " �Bess�re. 'tr`eci'j'ed
Mail Permit to: _
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