34 RAYMOND AVE - BUILDING INSPECTION (2) -PL4ms4 #ST-BEfiLf� APPROVE0 BY T*IE
INS,PJ=CTDB PfJ11JR Tp.A PEANUT B,EWO GRANTED
'1` \ CITY OF SALEM
No \ "� V S v�' Date1,)16
Is Property Located In Location of �I
the Historic District? Yes No_ Building a/» C✓�P�C
Is Property Located in
the Conservation Area? Yes No_
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) t'a?jr/Replace.
eroof, Install Siding, Construct Deck, Shed, Pool,
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: /
Owner's Name 0/�Ad/cu,� 1
Address & Phone 9 41Ts�
' Architect's Name
Address & Phone / // f
Mechanics Name /JA fed / ���iny
Address & Phone :C&) C 16eW
What Is the purpose of building?
Material of buildfrg? If a dwelling,for how many families?-
Will buliding conform to law? Asbestos?
EsBmated cost �f 000. City License 0 N P' state License M LoRome Improvement
Lie. ! X
r Signature of A plicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OFWORK TO BE DONE
�J
S• T/1 '`� �/6 Ly /lC /LoG
_ e
MAIL PERMIT TO:
55
O�l�D
No_\ —�V�
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
APPROVED
TOR OF BUILDINGS--