27B MARION RD - BUILDING INSPECTION What is the current use of the Building?
Material of Building? if dwelling.how many units?�
Will the Building Conform to Law? Asbestos?
Architect's Name The Chimney Guys
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Address and Phone�a sdyRsA� n+orl► ( )
Mechanic's Name -9900
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost Pro ed$� Permit Fee Cftlation
Permit Fee$ Estimated Coat X$71$1000 Residential
Estimated CostX$111$1000 Commercial—An Additional $5.00 is added as an
Administrative charge.
Make sure 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 X
Date S'- L-07
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PUBLIC PROPERTY
DEPARTMEINT
IQ\NG�MAYOR
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�ruS.�gl1:5t'ri5 01970
14197674E-959S FAX 97L740-9146
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building:
Property Address:- — ------------- - - - -
0''7 - Q /P1A,C/o-0 �c1
Property is located in a; Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: Ki
Address:
,,, - 9 r1�9/2 I c7.✓ led
Telephone: -j 78 7 `>'/ -760-7
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation v Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (so Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
The Chimney G s
P.O. Box 4074
_ -ea--o -X+----- 60
--- Mail Permit to: _- - --