8 ORNE ST - BUILDING INSPECTION irllhff61AUST-BEflL*D4W0 APPROVED BY T44E
1NSP9CTDB.PRIOR TD A PERMIT B.EW G GRANTED
CITY OF SALEM
No. J ' `r� Date �j c
—4
s�Ya,.
Ward
Zoning District
Is Property Located In Building of
the Historic District? Yes_No Building
Is Property Located in
the Conservation Area? Yes No_
Permit to: BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) 600 eroof, Install Siding, Construct 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:
Owners Name
Address & Phone BjBi yyy-192 ,3
Architect's Name
Address & Phone f
Mechanics Name
Address & Phone S
What is the purpose of building?
Material of binding? dwelling, for how many farniilies?
Will building co ntD t to law? Asbestos? isis,, v
Estimated st/lY 6-ff�0 City Licenser 2/ %9 State U N
Jq�.d� liarae Lvproveaend
Lie. E�y_Q2
Sig ature of pplicaa
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK
7TO/—BE DONE
C
Fd
r .
MAIL PERMIT TO:
L,5)'/90�
J
ti
1
No. 2
APPLICATION FOR
PERMIT TO
LOCATION
PER \MIT GRANTED
e
APPAOV D
INSPECTO OF BUILDINGS