2 BARR ST - BPA-05-706ROOF -P�VMT-SE f`ILEBA N A?PROVE0 BY T+IE
,w5pF_c,TDB PWB TP A_PEANUT B,EWG GRANTED
CITY OF SALEM
No V vt \ Date a:--) 7 —0 s
Is Property Located in Location of
the Historic District? Yes No 1 Building
Is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof Install Siding, Construct Deck, Shed, Pool,
Repair ace, 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:
Owner's Name �i� �1 I�PtJ l� C X �,C.
Address & Phone
Architect's Name
Address & Phone 1
Mechanics Name
Address & Phone �I
What Is the purpose of building? ��ti-f(e Ace
Matedel of buying? If a dwelling,for how many familles?
will building conform to law? !il z Asbestos?
Estlmeted cost v n . City License a< N A State License 8
�S Ov 0u Wn Improvement
Lie. i
Signature of Applicant
SIGNED UNDER THE PENAL
OF PERJURY
DESCRIPTION OF WORK TO BE DONE /
oi�,-o d P 7- le-f, '1 3uaTwrC l aJ 4 t
MAIL PERMIT TO: � 4 S'fi cS )4 (Pn , /vim 019 Y�
♦ }h 5.
APPLICATION FOR
PERMIT TO ,
LOCATION. /
PERMIT GRANTED
APP fU
INSPECTOR Of BUILDINGS —
s
t