20 ABBOTT ST - BPA-04-872 ADDITION OF BACK OF HOUSE ll
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JAI.S+�FZ=611 ft;R 04,AA P. INC GRANTED '
CITY OF SALEM
N d�� l��\ Date
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Is Property Located In Location of
Ow Historic Dtstdct? Yes_No_ Building
Is Pm wrty Located In
;r do conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCB8tiNG
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:n
Owner's Name f r �( L dO�`
Address & Phonei
Architect's Name
Address & Phone If
Mechanics Name
Address & Phone ,15-ifs ��` r005 •f--,�e (elf �d- �`� t�7 Z"Zd Z
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what Is the pr,rpose cl bWldlnp? 5L`s' (lfiGat
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mdww of bWldinp? (1000tQ B a dwaNY►0,for law many IamYNs?
Will btlldlrtp condom to law? t Asbestos?
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Sig ature of Applicant
F v SIGNED UNDER THE 1110111INWOM
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT TO:
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APPLICATION FOR
PERMIT TO
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LOCATION �Pc `>,V/
PERMIT GRANTED
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IN PECTOF4 OF BUILDINGS
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DINING
12'6 x 8'10 KITCHEN
10'8 x 117
LIVING
12'6 x 16'3 HALL
6'5 x 13'6
UP
5' _ - ----
LIVING AREA
630 sq ft
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BATH
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ENTRY
6'5 x 13'_UP
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