R-170 LYNN ST - BUILDING INSPECTION (4) e
1 OVED BY T+IE
T DEMO GRANTED
�IT OF S EM
Date0.
i
' Ward
Zoning District
e,Rrpr, y Located In Location of
h' klle brt I316(Hat? Yes_No_ Building
�4ilProplNty I;oosted Ih
i.�aiedrvotlgn Area? Yea_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, onstruct Deck Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY &COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications: �) -
Owner's Name Tier #An As p -/;v u *.-I WHB/hg �•�'
i
Address & Phone i�/t oAI�J�nl SH't �' 1'??&Y -32
Architect's Name n/���ii �J 47' fSJaci�Trs
Address & Phone
Mechanics Name ( s)-O4itn9S
Address & Phone
What Is the purpose of building?
Material of building?_4o aOMQ 1�F^o.-"-q II a dwelling,for how many families? % ; - s
Will building conform to law? Y >'s Asbestos? � 0
Estimated coal 33G City Liosr"k State License
Home Impzovwnt
C� �W Lie. # Si ture of Applicant
S $ I�� Q UNDEk THE PENALTY
j� OFvRRJURY
DESCRIPTION OF WORK TO BE DONE
5 ,via
y
MAIL PERMIT TO: J lj �0 USA
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