74 WEBB ST - BUILDING INSPECTION DATE:
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED Q
Building Permit Appikatioo For' LoeaUoo of Building_74
'(Circle whichever applies) Roof Reroof nsla11 Siding Construct Deck,Shed, Pool '
Addition Alteration,Relmir/Replace,Foundation Only, Wmcldng
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PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector of BtWtiings:
The umdasigned hereby applies for a permit to build according to the following speciliiadons:
Owoeri Name: .r r! t,( L•e E�A+.t R 16 Contractor.
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C Contractor._
Street 4 •4(k er Quo(_ City � Stecft,
Sufi {M J} Phone (7'79) -74v- ,S/_f o State Phone( )
Amb1eact: City of Salem Liotl
Street City State Lk# _�M
Slate Phone ( ) Homeowners Exempt Form._.jm no
Strvdure: (please Circle) Single Family, Muld Family# Other
Estimated Cost of job S (S"5D0.
Will buildlog confirm to law!,✓es no
AsbeoWaT__jp v/oo
Description of word to b done:_
Drawimgs Submitted:__yeS_;Znb Mail Permit to:
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Stgnadrre of Application=S GN D UNDED THE PENALTY OF PERJURY
CONSTRUCTION T B � OMPLETED WITHIN SIX MONTHS OF PERMIT ISSUED DATE
R �yDepartment use only: Permit err Zoning
Permit fee$
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