18 PATTON RD - BUILDING INSPECTION 14�16il WTI!IEIRL494AG APPROvfO BY 744E
MSPECM PWR TD A PERMIT BEING GRAND
N011), ` �� CITY OF SALEM
\ Dft 0�
r` 1r� word
ZoNng Dlatdoi
ft Flla O& Did&" YN—NO� Build�'000cinglon of
Is Properly f ocNad In
ft Corroaaatlon Arse? Yu No
Permit to: BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, install Siding, Construct Deck, Shed, PTI,
Repair/Replace, Otherr_s_� t3aSe � �a, ii�
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby applies for a permit to build accordwig,to the I following
specifications:
Owner's Name M i CN p E L i-
Address & Phone 18 Pa Of Rk c97g1 7yl y7ol
Architect's Name
Address & Phone
Mechanics Name
Address & Phone f
What is ar purpose al b B*W
M"W of talklirp? B a dwaft for taw m ny tamaa?
Wa buk krp conform to law? Asbseas?
Es mated coat 000 aly I kwm a slat.LbM a
90.. Is4ro�sast
aac, fr
Signature o ice t
SIGNED UNDER E PENALTY,
OF PERJURY
DES,CCRIFr1/0N OF WORK TO BE DONE
MAIL PERMIT TO:
i
No.
APPLICATION FOR
ERMT TO
LOCATION
PERMIT GRANTED
19
APPRO,NFD
INSPECTOR OF BUILDI S
Yn
n�'
i CrrY OF SALEM
BURBING DEPARTMENT
HOULOWIE1t I10E NSE EXEminow
Plnae Plot
DA Z� O�
]oB LOrATION I R cc.4(v), i�-d sL4Z.. --
HOMEOWNM
p Wbff MAUZM ADDRBS! 5��
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umam Fmvided tba it ewwer sei as a�perr{ats:
DEFDCr3Q"CF HCWEOWN=
pen=(s)wW owns t parcel d Lnd on which bdahe mile or kroads m mift ou+vldek lbws k,w Is
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farm swocnvec A pcnm wbo eonsv=moos t1m a=home In a two-year Pc&A d "sot bt Omwidw d
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othot appliabic Saes by-kwa,rde omd ycpbdoat
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HONMOWMM'S SIGNATURE R
APPROVAL OF BU DING MnCTOR -
See orbs adr for sm code
HOMEOWNERt3 EXEMPTION
The code Sul"tbsC 'w7 b= w w pafw=b S-iv*fa wrhkb a boOft psmk il tex I Ad be
exempt f m du pwd was ottbb union(Section 30y.Lb-33eeealeg Of Cemtnretiom idepavieeet•
provided that b a bcmwwna atpia p pmm(s)for Wm w do.smh wsrlt,tbat siren bomeowaa dtilt a4
to nipwlsa�' .
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sy�yyot(see Appcodh Q.Reles and Re=ubtiiom ter Li�esin=Cemerrniw Er�w.EeeltiN
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nnikeaeed p«m 1A tbls erase yom Bard earntol proceed aiabtp the mi9eemed po�oa is ftwwld wlb
Ikcaaed Supa+isas. The bomeonier anins m wpervi�w r eqr�eapos416
To enstoe dne the boraeowamr is telly aw m ctlAlbu respmdbMdcs.msaq==m= im=qA%-tr VW
of dm puedl applicialm that dw bomco.vna e=XW that heMm mrdesa &the reapeasibgUu dtt
srryevbm Ym may rate to amcad and adopt sties a*nQk rdlkatim fw m in you commed0.