18 WISTERIA ST - BPA PORCH l Y-3
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INSPEXToR PRIOR TP A PERMIT BEING GRANTED
CITY OF SALEM
���MIT i
No..3®3—ZQ 0y \ Date �bl_
,
�qfL INC
IS Property wcatea In Locaciou of /
ine Historic District? Yes_ No_ Building
is Property Locatea in r�
Ina Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to: \ to
(Circle wnicnever apply) Roof, Reroot, instau Sic g, of ryN DecK, Shed, Pool,
Repair/Replace, Other: /i/�
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:
Owners Narne c
2 Aaaress & Pnone �S— f7 yy p s
Architect's Name
oAaaress & Phone _ ( 1
/ Mecnanics Name d
Aaaress 8 Phone 17,10 j,
venal is the P..wpose of 2
Matullal ul uuttuiiiq? it a awt wi q. tur noIv many ia,nitiav
wtli ou,tuing coniorrn to law? ASoestoSe
23 0
Esumatea cost IE)0, City License R NIA )SIGNED
ate Li se s d 5 S 2
3(j3 ZOdI� Baum Lupruvemeuc
l Lic. I lls yb
;gnature of p lica .
�3�o UN THE PENALTY
F PERJURY
DES RIPTION WORK To BE DO
✓�e � (fah 0��-�,roh .
MAIL PERMIT TO: 20 (�
22-3
i
No. 50 2)-Z0-0
APPLICATION FOR
PER,,Mrr TO
S�,y
LOCATION I
PERMIT GRANTED
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APPfIOVED
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I SPOCTOri OF BU WINGS
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