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002D HALSEY WAY - BPA-07-918 What is the current use of the Building? Material of Building? If dweiling,how many units? Will the:Building Conform to Law? _ Asbestos? Archked's Name Address and Phons. ( ) Mechanles'Name Address and Phone Construction Supervisors License# HIC Registration# Estimated Cost Pr - $ Fe•Calailstion __ _---- PermiFFeeiC22 �0 Estimated Cost X$7l$1000'Residential _--_- — ------- - —----- Estimated-Cost X 5t1/$1000 An Additional $5.00,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 penalty of perjury Date _ - r 0 � T r y or ^w or- - - f � Crn-otr NI ALx PUBLIC PROPERTY DEPARTbIENT HAYM - �ismFxsrouscwi - 120 WwtwNaraor SrR=-ls�ti°y,�rAStAdICslTI5:019T0,- - RL97e 7iS 9S4• =,'; b 99M6 APPLICATION FOR THE REPAIR.RENOVATION, CONSTRUCTION. DEMOLITION,OR CHANGE OF USE OR OCQZA-NCV. FOR ANY EXISTING STRUCTURE OR BUILDING i 1.0 SITE INFORMATION Looadon-Name: , _._i Can o/ _ _ __Building -__ Property Iq located in a;Conss&a0on Area YIN Historic Dlsirid Yft 2.0 OWNERSHIP INFORMATION 2.4 Owner of Land _ Name: Address: a - 1 gal ex4j f -, ©\4�a Telephone: 3.0 COMPLETE THIS SECTION FOR'WORK IN thnRTiu—.�.� BUILDINGS ONLY Addition Existing Renovation Number of Zlorles Renovated Change in Use New Demolition Existing Approximate year of Area per floor(so Renovated construction or renovation of existing building New Baef Description of Proposed Work: fz( p era r7f�9C2 °l— l%�l:m� l g' 8 C m/tc� S U�ea� Ci VISe Mail Permit to: It(D a-e e RCS V O 2(i lQ