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41 BELLEVIEW AVE - BUILDING INSPECTION 1- WAMInwam# Irrwn AApnovw By Im ��II�A'.fi�AlWfii LIIIANT�D U _ CITY OF SALEM �o• � �� or, Icy y.� c VMd mIY,NOlrw I is n"Wro Lao"Im h comw aam Avert . Yoh fb AUILONa P■I�r APPLICAI N POIk Pannk.to: (C ft whlolff m m") �InMM�� NdMfoBldt OMWW Dook SIMtd,� RMU PILL ONr 1IMMY•fsOWLXMY TO AVOW aLAYs N PIIO=1111 I TO TM INSPECTOR OF BUILDNOB ' Tha hewY apow for a pom* to build 0000fd'ftto fha,lo1owllfp OmWe Noma .IqQ r/<_ Ad*m t Pharr lsc //c' vie al ,4,/P c 9/-4 7,V 9 AYhhoWe Nanfa Addrew A Phone /6 VA' (8/001 ,r'Jr7 60S.3 AirohoMcs Name Addrw A Phone j 1 WmIsbpomil w kftl of cl,`n(I N a drwiq,for hm wm Mat YfN14Aiq ooiaoaa b level �� O ErNOW 000t fir�lorw• !N�tJoMrtaa / ekP i6/os— Of AppYorft S+oraye-T c- ��lIMMALTY' wd)iw,k,m of call OP PWAW OfIiOmR10N OF WgIMI TO n � PoS�-u�©ocP�r���, �-roc'. cyi'11 �o�s-�r-✓c� � F�x��Z Prey-�. S-Aora e S�Cd WJ k i'I Ae 4,, c cLd c MAIL PEP01ITT+O; a4k�.�:p 1/ec Zfl 1�-&: Ili y/&"ohi/c, S4k) 1 • � '� 5 �.�' _� ` e , . . r {U —� �� h, �� ,�s,.., . . �.t;.: 6 . . � �w,t• • � .. .., I �. oY; .+ �%y .. � � �__ —. W i 0F Sf Uad BunziNG DEPARTMENT HOMBOWNM UCENSE MMOMON Pleme pdd DATILlC^ a7—O`� 7081ACATION Qe It )I e w -A lle . H0lrffoiWl� 4�1 �P JIP✓�`Eu� /��/e A PRESENT MALINO ADDRE M The avreal,sa<ml%1ao d'hom cascaded to b+chde ewaerafa+i d* O arTw Ualu a Im and a Am Farb 3om8owmu to vWV as Lebo dos as pores t )iccna povided for the awotr Get as whterisa DEF04TM OF HOMEOWNMPenm _ wb interA (sw K owm a two d lad c w•&sludwd as dwcbW tsnrwas 000�7��kMWAR i m sw c b;a one n two c COA dwsllio{, A a aot bt eauldoai farm sotteaves.A perm�vbo eot>titrttets mat than cm lame in a ewo-7ets pviod . Bm'ldbg Officisal *m Wft be xsponnbk to aD n*wskPerk'm d The nrdasip W`bomwwmf uatmKs>csponsrbMW for=MPBWt Tft t Sun Basidlog Coded ' other appsabk goes by-kw ,roles and ttgabduL Ths tmdesipasl'boMeownd"arafia that hdshe todcsun b*C CIq of Salem BWWbg DepwvmK. in..b pctiaa V..dma atd regaatmcros and that W t wail=q*w M ttald ptooedma d HOW0V tGR'S SIGNATURE, APPROVAL OF B=ING INSPEC'JOilt see otLa side fiff=a code HOMEOWNER'S EXEMPTION The coat states that: -arq homeowm pertormiaS.vmk far wd>i�a bnildir�'> 8 req�tea abal tie . cmmpt from the p odsions of thb section (Senior 709.14-lJccosioS of Cowtnte Im Eoperrim Provided that b a homeowner aipsa p person(�)fat i6s to do.suci�that and homeowner sia8 ial mam%=wrwm=Wbo an thb C=Vim are iaoware that they an U m be on"Cwhmn eta supervisor(ace Appcodfa Qs Rules and Resulatiom for 1JQosin Camtracdbtn Swpervban.Seed.m .2.10 7hb bust ds.+arerress dkea mWa in serious pmblcmt.pardeo �the iosoeocr"O film an kcroscd pasont In thb case yom Bond earmot proceed as bst tie pe:foo tr twatid trldt licensed Supcnira. 71is bomeowmsr sahsS as supervisor r stgfmate sestesuSfU, . To came tim dw bormvsrrsN Is fak ew we of Wba-reponrSbi>ltleN msstiy eommm¢tlsa no4&a:n past of a*Perri{applieatim that the bwmsocrna cc"*&at bhhe mmderswrds the respoosbuldm ofa mpaviem You ma care to amend and adopt sues a twmkUn icatfm Sm sae in yew coammdw