0017 BARSTOW STREET - BPA-6-258 y[hN
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UP of carem, :01a!g!9arbU!9zt#S;
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Building Perdt AppUeatioo For. Locadoo of Buildws
'(Circle whidwver applies) Root Reroof, sell Siding Consum Deck,Shed.Pool
Addition Alteruion,RspaidRepypG,FauxMm Only,Wreddng
Older.
PLEASE FELL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector of '
The
undersiped,busby applies for a permit to build according to the Iollowias gedtiwtionc
Owner i Name: S a l�s�o Cootrsetol
sow C) City 6a/gy_ Street ,
Suft.Ll1f- Pheae 070 7gS—Iq zJ s Ph000( )
Architect: City of Salem Lielt ,
Street City s L&OF
s Phome ( ) Homeowwn Esempt Formes ao
Strsreare: (plaaoe cif&) Single Fawly. Multi Family N Other
Eatimated Cat of job S2S
Will boilOng adira to law!,�yes no
Amboato ? �so
Desc iptioo of work b be 6ae:
Dnwinp Submitted; no Mail Perak to:
SiBaature of Appticatfrsr GNED UNDER THE PENALTY OF pgLMRY
CON UCTION To B �.OMPLETED WITHIN SIX MONTOS OF PERMIT ISSUED DATE
DqwlrtteDt use ody: MaplLot----r—
Permit fee i
C01111UN'TS: