10 HODGES CT - BPA-2008-384 NEW KIT. & BATHS, ELEC, HVAC PUBLIC PROPERTY
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APPLICATION FOR THE REPAIR RENOVATION. CONSTRUCTION. .
D&MOLITION. OR CHANGE OF USX OR OCCUPANCY. FOR ANY EXISTING
9117 RMUM OR BUILDING
t.o SITE INFORMATION j
Location Name: BuddkV
-- - -
Property Address------- - -- -
/a c/e cT _5_s,4GE�7" MA diq�o
property is located in a:Conservation Arse YIN Historic District YIN_iv_
2.o OWNERSHIP INFORMATION
9.1 Owner of Land _
Name: ygw-ri/ vcl 5clv677-7
Address: PO
Telephone: 717 , e,-9•r/G
3.0 COMPLETE THIS SECTION FOR WORK IN E7II821DIQ BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use 2,- New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
Pb-wje ! /k-57v� s.
Mail Permit to:
What is the Current use of the Building? Z
B dwelI how many units? . . .-
Material of Building? GfiGc o
Witi tha Building Conform to Law? a5 Asbestos? k'
Archfted's Name T� _
Address and Phone 193
Medunles Name ``' X - r
and Phone
CoACdodns�tructiim guperv�on Liss o HIC Registration 8
Estimated Co ��oi��Pre�o'a�d i oGD. Permit Fee Calculation
Permit FN i 7/A ,i Estimated Cott X$7/$1000 Residential
—_ _ _._ .. _ ._._ _. Estimated CostX it1/$1000 Commercia4-----.-- -
An Additional S5.00 is added as an ..
Administrative dtarye.
Make sun that all fields are property 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 Gl, 2z_0"7
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