0021A MARION ROAD - BPA-08-577 What is.the current use of the-Bu ding? Psy' eel I
— Material df'BuiIdlnq?
n0 11dwelling,how°many units?
Will the Buildin�'Conform'to'Law?. - Asbestos?;-
Architect's Name
Addrese and'Phone
Mechanic's=Name ��"^.. .. . . ��✓�-,, � (n,S ,.4��f l � :,
Address and Phone
Construction Supervisors Ucen"14,eS53 'G�1 HIC;Registrat[on#
Estimated'Cost of Project S c3 fl a � PertnR:Fee.Cale ilatbm
- Psrrnit Fee S Estimated Cost X.-i7/51000`R$sidentlal.
Eofnmerc!l
An Additional`$5.00.Yo added'=as am
Admini"strafive:charge. - -
Make sure-that ail flelds.are properly and legibly written to avoid delays ln,p'fwsssing;
The undersigned does hereby apply wa=Building Permit td build°to the above stated
specifications. Signed under penalty ofperjury
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I�UBLIC PRORERT'Y
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�y APPLICATIfON FOR'I`AE REFAR. RNOYA'Y'I N� (CbNST.R r ON ,
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Propetty:
1:0•StT<E I,NFOR., TION '
L•ocatlon Name _ C _1C11 af? c�••' 8u1 IdInS.
Addre „.
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Z Q OWNERSHIP•INFOI�NIATION777
Addresa5 l V�'lQnbn
Telephony:
3`t1COMFLETE,THIS.SECTIbN FOR WQRK(N'EYi_ ia�_�u�y `UILDINGS bNLY
Adtlition :-
i
Renovation
n
Number of SFories Reovated ,
Change in,Vse Nei
Demolitionxiatirlg.
Approximate year of Areaper flaor,(sf) Renovated
consiructiolt orxenavatiod. `
of°eXisting•building' , New ` , .
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