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21 PROCTOR ST - BUILDING INSPECTION (2) •��3 3 11%W61101WORfldNk B MiM VGD BY IM IOB PW TO A`.VMW UINti ORANTkD _ CITY OF SALEM NoLk 1� Wad ._s ZW"oama ft�0 4b7M Y..No �•e cso. or � L M P WNIV Laoobd In tilt+CWNWMaonAnd . Yr No BIRDNO PEIBBT APPLAUTLON POIk Pormk 10: e (Chb rrhlpFr W appy) Rod, Re Irolall Bkilrr rtgt DaOk. W , POaI. Ulaf.�i'1 /F"2a� 2 PLEASE PR L.OLIT L MMY a COMPLETELY TO AVOW OBLAVS N PROOEBBl110 TO 111E INSPECTOR OF BUIL.DM&- The hMNy// appbs for a pork to build aoowd%to Wain d q 0~9 Name S 7 /mil � / ��� la/—a Ad*maPhone 21pr©6jd2r S� Safeyn j97X1 395, yl 9 � Arohknrs Ntlma AddMW A Phone ( 1 MWmit a Now Addrm A Phone ( 1 wo is b pmp>M it Olaw 5 ; � z f\ mam o t rraor N a drwrnp,for how WAW r.nW Mar ko"oo*m b Ifaw'! j 8 GdWA d OMe uo d �. 1l 'F� or of PINR TM PENALTY oESCRIP�ION OF WORI(TO BE DONE I-T-�. rn p �s� � o v fie- �L., � 1 x 2 � •0 2 TI MAIL PERIWT TO• r , � .... . . _ r. .. .� u .� , :' �. � . ,� . _�.. �x< , ,,,. . . . _ ..,,;� pry`v h 'la.. � �� - � \� .. �' i A .. BUILZI NGDEPAPMAE I HOMEOWINFA LICENSEE MOMON Plane Pda JOBLOCATIM 2HOMEOWIM ? AMWX* PRESENT MALWO ADORES! Tbc avraa.a�rmptiw af-bomwwacre wo wcuded w irctu8c ew""OFMPM d*dl6P dT" Units a leas and a&row such bomeowaas to a0e sa bdividh> tx hire wbo does am poses d liocats,.prvvided dasthr ewsei set of"Fenism DEFD4TMdFHOhffVW M Posoo 0)wDo�vwus s Pad of lead an wWch bclthc asides Of breads w reside. o wfdefi �mRd intended to be.s one w two family dwdlin&smmd d or detsehsd saucaaes�1 aeil bp�s w farm savesoea.A persoh wbo consv w more thsa vac home in a twoyoar PC6Od sha s bomeowaa. Sack-hmaevwaer staS submh w the BuDdbg WICK=s w&C"Potk w** tlnt bchhe be le w all such wok pafasmed P� Bw'ldia5 Otfuial. b The undusivad-homeowner=ww responsibility for complu=wi*ft Suroe Btu Code am otha appliabk goes by-laws,raks sad te=nlstka< The,mdcsi -homeownd'mrdfia thu hdsht WAwstan&1ft CjW of Salsa Bn%ft Dgw=w t. with acid d she will fly P uircmctas and that hl " minimtaa inspection procedma and req . nqwnmam HOMEOWNER'S S)GNATl1RE '_ OVAL OF BVl1 D AIGWSPHCTOfI APPROVAL See other S&for Sou code A . 1 HOMEOWNER'S EXENEMON The code States tbW 'arty homwwxr perform nS dv*for w Wcb a bat7ding pamdt is mq&W alas tie eeempt from the pto+isiom ort h section (Section leyJa r Uccasioi or Construction Supavbore provided*9 is a bomcowsta caeaies a.pawn(s)for Aire m do.such wosl4 tlm limb boaaeowaa sins so as sqavimr MW bameow m a wbo me ibis exemption are imaaasc am they are ass»mins die MOOD:fblsdq a[s supervisor(sec Appcodia Q,Puks and Jtepuiarioss for Liocosing Construction,SuperviseM Secdas . Thies lack of awartmess oilea restths in scrims problems.partie"]v�Wh9?At bomeovract hh" Uriiaaawd per:om In Ibis case your Eosrd cwawt pivoted aiaimst the taurecmeo pal a as k wootd wm licensed Supcnisq . 73e bomewser acting as supervisor Is•himrt*rnlroasbh. . To cnsksc that the hotneovrrtcr is fully aware or hi/ha.teiporan'b113tka,rnmq oummmddes regkdm.m pal of the permii application,that the homeowner ecn*that belshe woulumda the respmsbiN a afs supavisor. You may can to amend and adopt and a formkmNiieation fm coo in your eow=WW. ruEuc rRorpRV U P^WrMMT ;- 120 VOW MIMe11Om Man,$R0 FLOOR &MAK.MA of o70 TIL (979)74d-MM DR.ago FAX (Y7p 740 NB" STA14jY r{/10y1CZ. AIL - - - -- DL2%a OF DEB=AFFIDAVIT Ia u=daooe with me povioom QfMM c 40,S34.1 aclmowWp dw m a=oM= daMI&S 1'atvdt S- -A debris nnkmg Sam the=ostroodom nd ft Sm"and bit this DmI ft Pe®it Ad be dLpmed das a popadp Nomad did um disposal Awft,as deft d by)AI$,c n L SIMAL The debds wiff be disposed deb L odonafFacEW Sip an dPeamk AppHoW Dab FULLY campl ft the SollowiaS mtogiaa; DUMB PRM CUMMY) Nsme d wmk App&ft n q ,4 0 Pi®N soy Addm%(Sty&Stm ,"Ver o-q� nw above stoft rejoh a that debris Sam the demolidaq naoovadM rehab ar odwr Whndw otbasgft or sEr wren be&goad m a popafy-used mosdAvamd�pogi sty r deSoed by M(it,cA S130&and the buiWmj' pumiq or ficmo m to Mew tiro foesdam tithe faeaaky. �' 1 _, . . . } � � -� i P z a�g¢n�D 8uajea to a a <P'o�a1 LY a,�Y o�i_Wz utfiorit,,h�yFF =., a. �a• r eaoa. s; "MITI'%TH-' G6E.C I OL'i. CB;vL-LEfeiCF.dF'!. c i O 3 A4 I � - l f _ goo i