HomeMy WebLinkAboutBuilding Permit #85 - 21 CLARK STREET 8/2/2007 H°oTH
BUILDING PERMIT
TOWN OF NORTH ANDOVER 3? '•
APPLICATION FOR PLAN EXAMINATION "
Permit NO:
Date Received
Date Issued: " 2'�� Ss�caUSE�
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building 0 One family
❑ Addition 0 Two or more family k ndustrial
❑ Alteration No. of units: ❑ Commercial
0 Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition 0 Other
e� DESCRIPTIQN OF WORK TO BE PREFORMED:
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Identification Please Type or Print Clearly) . 4l.L
OWNER: Name: Phone:
Address:
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ARCHITECT/ENGINEER Me-vyl m a.etc CA)
hone:
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Address:_ �G PApk cXr4.f. Al94rayer� N14SS Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ tLLao, roo FEE: $ �5+� foo
Check No.: Receipt Recei t No.: d
s do noy�
NOTE: Persons contracting with unregistered contractor r
t have access to the guaranty fund
signature of Ager%#i gn
meter `, t nttct
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