58 BEAVER ST - BPA-2006-450 SIDING {.{L{� APPAOVE0 8Y 774E
MSPF IOB PRIOR TD.A.PEF1W BEING GRANTED
CITY OF_SALEM
No. '�\, \ Date
Is Progeny Located in Location of
ffw Historic Dlattict? Yes No_ Building
Is Properly Located in
dw ConservaW Aron? Yee No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, onstruct Deck, Shed, Pool,
RepaidReplaks, 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 zaq el L
Address & Phone ,eL�,;Fva,�l .Q
Architect's Name
Address & Phone L 1
Mechanics Name
Address & Phone L 1
What is the purpose of buWft?
Matedal of building? If a dwelling,for how many famlies? 2
WW building cordorm to law? Asbestos?
Eswnated cost CRY Lloense• N A State License N
scree Improveaent `
Lis. /
ignature of cant
SIGNED UN R THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:.
No. 'D
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT,GRANTED b
lz
Acc ROV0D
INSPECTOR OF BUILDINGS o
r -.