63 PALMER ST - BUILDING INSPECTION PLAM-N HST-eE filE�..APPROVED DY T44E
LW5P CTDA ,PFWR TP A.PEBMIT BE NG GRANTED
h,
CITY OF SALEM
Date O L
K <.
Is Property Located In Location of/�
the Historic District? Yes_No_ Building
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
epaidRe ac Other:
PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
1� TO THE INSPECTOR OF BUILDINGS:
n The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's NamePtr� �� U
v Address & Phone 690t,?_�( A) GT ncx+h - 00) 12(a
Architect's Name
Address & Phone (� 1
Mechanics Name � n 1,�S 4
Address & Phone ISn iff4f>>)f
What Is the purpose of building?
Material of building? !RC 0 If a dwelling,for how many families?
Will building conform to law? —Asbestos?
Estimated cost City License n N p' State License # 2�
Home Luprovement V
Lic. I VVV
Sigh4ure of A licant
SIG ED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
ke 1a&L 14oxA- roc rt°.i_-ze waU ki> b4ywon
p6L2�e-6
MAIL PERMIT TO:1i�tal\/ a 2,11 lA/1L-W� -PiP, oa-tll'
.1.
No.
APPLICATION FOR
PERMIT TO
ft
LOCATION
All
PERMIT GRANTED
APP tOV�T �
INSPECTOR OF BUILDINGS
4
S- / o To
o I•
BEDROOM BEDROOM BEDROOM {
1 I I
1
BATHROOM ILI CL 3xnA ;� {
L I
'CL. {
MAIN {
G'L ENTRANCE t
4L 40.3' 0 i
UNIT 3
AREA
l
BEDROOM 1089 t S.F. {
I RoD w� I K I
Fbu 7 --
EN i7 4U,
T qOl�
r / .
I I I
{ 1
BEDROOM I
I j
I BEDt200M
UP `
I cL _
I e I p
I
34.0e I
KITCHEN I
MAIN
ENTRANCE I
VN IT S i
A �`.�.do BATH j
ROOM I
DINING I
! ROOM I