96 WHARF ST - BUILDING INSPECTION �D 3q fL11dIS1NJ r*Ef ma£ * o APPROvEo BY TW
O�lo� JdSPJ:tIJrIB PFJIIGA TDA.PEAWT IIBWG GRANTED
CITY OF_SALEM
NO. 9 ou 06-30 �6
is Prop"Lacow in Location of
the Hhbdc MiloYaa No� an+- Ina
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BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Reroof, Install Siding, Construct Deck, Shed, Pool,
JRWp r eplace. Other:
PLEASE RLL 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:
Owners Name b-+u,`& Q `✓gNe
Address & Phone W6 1 1-f3-- 0-0
Architect's Name
Address & Phone ( 1
Mechanics Name
Address & Phone j t
wrm is tee Purpose a twYdlrp?
m"W or tnrldlrq? I a dm&q,for how many tNUM?
WII t kWQ Wdaff r to law? ASDasWs?
Eatl mm cost S City wens o N A stale Um"e
�DOd Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT T0: Gj 3 /7 5 7
No. �
APPLICATION FOR
pp PERM 1IT TO
LOCATION.
PERMIT GRANTED
AP WVfD
INSPECTOA OF BUILDINGS