26 BALCOMB ST - BPA-2006-850 SIDING & TRIM C� U� 3 y
-PLA"S*WST-9Ef#L£%4N9 APPROVED BY T44E
Wft"DB Pt3 R TO A.PEASAIT MING GRANTED
CITY OF SALEM
No Oats l
Is Ply Located in Location of
Use F W&k Obtdd? Yea—No �! Building 06 5:'L ' 't
is Property located In
the Conaervadon 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 PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owners Name _ ��`� �` � Q�
Address & Phone ( 1
Architect's Name
Address & Phone 1 )
Mechanics Name �—
Address & Phone 7k) 7 YT S� 2
Who is the Purpose ct twildlrq?
McWW of building? ° z� It a dwett",for how many families?
wo bWlding cordomr to law? ^�'_—_Aebostos? Zv'-O
EstknetedK Id, coo,o o City Um"r N A State Uoerrae ere D�0 jrG
Notes Improvesiant
Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO- o y G,z c n" o i r 76
I
No. O
APPLICATION FOR
PERMR TO
LOCATION
PERMIT GRANTED
2.0
AP/PROVFD
�m
INSPECTOR OF BUILDING