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67 ORD ST - BUILDING INSPECTION (2) i q%ww -,0EfNANww9 APPROVED By TWE JWPRC=Pow TD A iPE911R BI NG ORANTkD CITY OF SALEM Dan Vftfd _ ZW"L�tlm of f Cl Iha Fhblc DY41d7h Ye NO ft"di s la AWNIy Wofbd In ha GwWWvwlon Ann? YM NO fC Pennk to: BUILDM PElW APPLICATION FOR: (Chb whiff wm apply) Roof. Rafoof, IWAN Skft CoreGrM Mak. Shed, RW&Mlplaoa. Odw PLEASE F"OUT LEGIBLY A CaYPLETELY T'O AVOW DELAYS N PROC� TO THE INSPECTOR OF BUILDINGS: ' The ur4wsoW hereby appbs for a permit to build accorditto t o.fokowkp Wdloaft": Owner's Name 056 76 K 6 E Address a Phone (41 eo 2D S T mn 1 -7 Archkect's Nwne Address A Phone ( 1 Mechanics Name Address A Phone ( 1 whr a tlr prpm d MMW STORE 1/Ai2D T o l r mdo W of b~1 /E7 A/ N a dwMYq,for how mmr gnin4 EdMofad Cod a 6 rl CRY UQn • err.Uo « ue. , ° v"m d A~ OWED INr1DER THE PENALTY' of P¢RNNIY DESCRIPTION OF WORK TO BE DONE LACK SMPl-i— PkCLU f4RR6w(If ANvF� SN E z) � ,q' x /o � n � ` � i N 51 p e e x rsr l nI-G CQ1-6 C- w c h /A/ 9�c& 1T... MAIL PERMIT TO: (o l D kP S T ., � ��. ' 'C.. � Y ... ��k •� n.i. . i ` �...♦ �+��n Xe A i �" ..,'. rY Wi.t «4. .�1. � vi. M1 e G. �� , �_ , © , � � . .w�. .ram - r � � � � � � � - CITY OF SALEM BURDINGDEPARTMENT H0ME0WM UCFNSE ExEmr77ON Pkase Pdtt • DATE / 'Ol7- Q 1�•�� 7 D �CD ST ' ' Hol�oar�t (�f 02�� s'•� ADS 'HOl=win 17 Tell— 3 o2 .5' S TELIPHOW PRESFJ�Tf)dAB.II10 ADDRF3! l �/ 0 2� S7 . The cwrcrs.cwnVJoo d'lameownas"was naeaded b brclode ewoct-mpcpp d*'�P WMrWO Unhy a lean and p allow each homoowness b a�e.n bdlvidtrllioe hbs who W. aol p.wes a ]iame.pQvvided thin the ewaei aA d w'crvMea . DErftGTM OF HOt#2CWH= • Pcrsoo Q)who owm.portal d kad oa wbad►bchhe insides a Lretde b teshk,oa�vhieh three ir+R r Snta�d.d b be,.one b two firAy dwt2n&sttadt.d or&&dad Nncwm aMUM b tat b the aadAR firm svncwm A ptum wbo constructs mom thm anc lame bk s twOlm Period*A lathe asd a bonseowaee. Such`homcowocf sha4 eulmdl b the Bnldirg OJfmb%as s lbssp b as Bw7dind Ochs i,that Wow bt tapormbk to all ends wak performed tattles*A PU tannidEL .The undersip W-bomoowne mm es tesponsibpity rot compiisna vftlbt State Daft Code md ' wha appgcabk foes by-laws,roles and tepsbdog, The undersipad-Mumwne s Ufms that hebhe mA=W ds the Ciq of Salem Bun ft Dgwum a. mitummn bwpwdcn proadma atd tegtotemcros and tint ldshe win comply wi*said ptooedwo d tegsir®ost HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING INSPECTOR Sec other sack fm state code HommowNERr3 EXEM rn(-)NI The cods nata tbac 'arq hommowwer pafwi*i viadc for wrbicb a boD ft pamit Is rcq*W sbsl be cxcmpl b=the pmisionr or"secdoa (Scniaa»p.U-lJccaslaS 09 GsastMOWN Saperlbwt• provided that it a bcmwwau c r4%u a pers=(s)far bbe to do.web worts,tbM sirm bomeowau datD eat Muq bomwwm=Who nee this aamptioo arc mawan tort tbty ns umwhs the ieVOW&WO dS wpaviwe(sm Appcodls Q.Auks and Regubtiou far liaell mg Geoseraedoa EaperAveM Smc*a .2.24 This buk of se•arerwt efkn rwhs bn aeriors probleam.parderrly�w Lea the boeeoarau hbo urjkc ned persona In this ease yew Bond amrol proceed agalmt*A peeloa sa(twonld va Ikcmwd Supeniwe. The bomeoxier atYiag<u wperrtaw is tgiateb retawAlL To emn drat the bomeotvm h fa v aware of wh a uspmebltides.mare oommmddes tagdm.as part of ds permlt applimdon.that dar bomeowau col**A be/abe=A%M mnda the re wmslbmm eta wpavitot. You m q an to ameod srd adopt Brim a immktr>ibodoo In aas In yoar a mmml0'.