27 SILVER ST - BUILDING INSPECTION 00
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Loadm of SuRSof
BuiwioS Permit AFplieatioa For
'(Circle Wwdwm appli s) Iteroof. install Siding Conswct Deck,Shed,Pool
rlddi ' Alteration,Rqm i /Pqg o.,FotW mwn only, wnd ni i
PLEASE nLL OUT LEGIBLY& COMPLETELY TO AVOID DSLAYS IN PROCUSING
To 6c Lnpm of Bui)diags:
The tasdmaijned hereby applies for a permit to build acc aWW to the Hollowing apodlkatieoa
Ownersi Nape: t-t4 i z & N w Aga Contractor a m
Street 2 7 Si Vtlz �V City 5.�vy) Street
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State Phone (`118) 4-19- Inl'F2• S M per( )
AmWsect: City of Salem Lldl ,
Street Ciq State L Bp N
Stale phone() Bonammen rxempt Form—yea so
StrticaAM:(please cmk) Si%k Famil). Muw Family N___odw
EatVNcd Coat of job S O O —
WiB bulling tnatir a toAsbMm? hnr!� s no
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Ducdpdm dfwe&b*be i w 14 Xis a dl di k M 40 � -Cr h{d 40 P
Drawiap Submitted: yes_ no Mail Perot to.Z VG2- �p-G P/1—•
Slp re of APp�,S GNED UND R TBZ PENALTY OF PZRJURY
CONSTRUCTION TO Bll�OMPLETED WITBIIY SIX(t7 MONT$S OF PZRMIT ISSUZD DATE
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