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10 ALMEDA ST - BPA-04-113 VINYL SIDING gdtIST-BE ffLf� APPROVED BY T+IE .WPFCTD-13 PM13 TO.A.PERMT.BEWG GRANTED CITY OF SALEM No. ( I '�-2i� �wf �;\ Date 'I. 30•n3 �9�1MIN6�� T Is Property Located in Location of the Historic District? Yes_No_ Building ib A l y,zda 5� . Is Property Located in the Conservation Area? Yes No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, nstall Siding, Construct Deck, Shed, Pool, Repair/Replace, er: 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: Owner's Name Address & Phone In AIM `l44 - Goan SwlLYV-+ 1 Ma . Otat'fp Arc Address & Pho ( Mechanics Name RMA- 4nme_ 343 Address & Phone worca +u� Mn . otbo7 56(1 ) `lL-1 -�IZR What is the purpose of building? Material of building? If a dwelling, for how many families? Will building conform to law? Asbestos? Estimated cost 15,000 City License # N P' State License # $q S Rome Improvement zic. # 1165393 Signature of Applicant � SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WOO��RK T( BE DONE 4Y.1',, V) MAIL PERMIT TO: 1 C 1�w•c ewfu 1 No. ji, 3 " 7-:c5-D APPLICATION FOR PERMIT To LOCATION PERMIT GRANTED-- -2L LO-3 2.0 AP VFD INSPECTOR OF BUILDINGS