8 BOARDMAN ST - TBA-2004-149 SIDING S
g0tiSTBE fIL{-� APPROVED BY T44E
IMPPC-TDR ,PFWR T-O A .PERMIT BEWG GRANTED
CITY OF SALEM
No. I 1 �-Zb0 ( `y� ..� ''p� Date Z—rL1L3
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\y�y! •.Ira
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Is Property Located in Location of
the Historic District? Yes_No_ Building 6IJARD,k,#-) 52
is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install 631Construct Deck, Shed, Pool,
Repair/Replace, 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 m/4R�N 13i4T�S
Address & Phone #3Dia,? bykA^J
Architect's Name
Address & Phone ( )
Mechanics Name 0 fi b K24
Address & Phone 6/-T) �,2,2- folaG
What Is the purpose of building? 19 i4?eA g ,
Material of building? If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost t D I DD 0 city License # N A�` State License # b 3 9 ys 9
Home Improvement
Lic. 1 7
4 (\ c
1/.,�G 3-� 'R�J - ./
X Signature of App icant
t I y SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
N�4 ��✓�,
MAIL PERMIT TO: -e,)L4 U St• gam«LS !�1 �S
No. I — ate
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
APPROVED
INSPECTOR OF BUILDINGS '