7 PRESCOTT STREET - BUILDING INSPECTION UPC 74339 l w
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Plans must be filed and approved by the Inspector
prior to a permit being granted
CITY OF SALEM
No. q6y- 9`i"/ Ward
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HISTORIC DISTRICT? Y N � � v` Date��l9>'y
IF FOR SIDING, HAS ELECTRIC '" or7'`'/`/— ?J5/
Home Phone
PERMIT BEEN OBTAINED? Y N ���/MINE Rus Phone 777' —3333
APPLICATION V�,( P CQrc�/
FOR �1
PERMIT TO
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the
following specifications:
Owner's name and address ,/31.t7�1� '�.,
ti
Architect's name
Builder's name f�l � f
Location of building, No. L1 !1
What is the purpose of building?
If dwelling, # of units? �Material of bldng? woo 01
Will building conform to law? Asbestos?
Estimated Cost 6 Q Q Cit State Lic.#
®/ 6600
Home Improvement License #
Signature of Applicant
SIGNED UNDER THE PENALTY OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Mail Permit to: s /
No. -+ `� ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location 7 r,E 5�E5
PERMIT GRANTED
App ed
Jcq � fB g Inspeat ►