6 TAFT RD - BUILDING PERMIT APPr
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13%f181M1 "FE 40 OVEO BY T44E
j� 1 lQB ?D P .13 MS GRANTED
'\ CITY OF SAILEM
No.
We
is Propwty lecatad h ✓ Location of
Ise Hlstodo MOW Yak_No Building
Is Pmpwty Loceed In
ft C9n Mao Yak_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Remof, Install Siding, Construct .Deck, heC Peci,
Repair/Replace, Otherr,
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCBJti11NG
TO THE INSPECTOR OF BUILDINGS: ~
The undersigned hereby applies for a permit to build according to the folk►wing
specifications:
Owner's Name
Address & Phone (-o 1 p- k afs -1 Ik - l9 a
Architect's Name
Address &Phone j 1
Mechanics Name ,
Address & Phone
:!Ifial
What Is Vw purpose it DuNdMrp4
Md8"of buMdlrq? y�1�t�/k-� I a daeftV,for how many famba?
WN buk"cortorm to low? mos7 ?I s
Edma!ed cost. ��U=_
CRY Llarw+ N �'' r►
Lie. / ('
Signature of Applicant �I
SIGN ERJURY UNDER THE
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT TO r
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S�fup:. i
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44, - - `
APPLICATION FOR
PER/MIT TOO
LOCATION
PERMIT GRANTED
0/0
APP fD
INSPEGTOR OF BUILDINGS i
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