11 BARR ST - BPA-2006-141 DOORS NO. �\-'v \1-e
APPLICATION FOR
PERWr TO
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LOCATION
PERMIT GRANTED
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INSPECTOR OF BUILDINGS
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CITY OF SALEM
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Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circe whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
RepaidReplaoa, Other. 2Q�L�2Q /—"2����Y /�z�2-
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS 114 PROCESSMG
TO THE INSPECTOR OF BUILDINGS: '•
The undersigned hereby applies for a Permit to build acxortLip.to the following
specifications: j
Owner's Name
Address a Phone /L� (�7k1 7y�/_ �o —
Arohitect's Name
Address a Phone ( 1
Mechanics Name
Address a Phone ( I
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SIONED UNDER THE PENALTY'
OF PERJURY
DESCRIPTIONC , OF WORK TO BE DONE
MAIL PERMIT TO: