55-57 HANCOCK ST - BUILDING INSPECTION use of the Building?
What is the current 3
Material of Building? ��D/J I dwelling.how many units?
WIN"Building Conform to Law? — Asbestos?_
Arehitads NarM
Address and Photo
Mechanic's Nam* O`
Address and Photo Rd
Constuction Supervisore License is HIC Registration
Estimated Cost of Projed S S� Pemdt Fee Calwlatbn
Permit Fee i Estimated Cod X$71$1000 Residential
-- - Estirnstsd Cost X$11/i1000Carnmercia4-------__.. _
An Additional $5.00 is added as an
Administrative dmrg*.
Make sun that all flsids 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
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PUBLIC PROPERTY
DEPARTMENT
,;,.o��usvO.IiCIMl C�
we oa 130 WwSUNwWO STU=•suMkmsdnsolrro
To.m74"Sft•FAX 97e•7404"
APPLICATION FOR THE REPAIR RENOVATION. CONSTRUCTION.
DErIOLTTION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: (?� eu0dIM
------- _ propertyAddresc-- ----- ----- ------- - ------- - --
��G� W,5:5 ®197e
Properly in located in a:Conswistion Ares YM Hbkft OWNIct Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land _
LN]ame:
3.000MPLETE THIS SECTION FOR WORK IN En3X1h0 BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing x
Approximate year of Area per floor(sf) Renovated
construction or renovation
of existing building New
Brie[Description of Proposed Work:
Mail Permit to: --- _- _