9 BOARDMAN ST - BPA-2005-350 WINDOWS ,o
S
4PUMIM M13EfLC44ND APPROVED BY 741E
MSPFCM0 PWR TD A PMW BEWG GRANTED
CITY OF_SALEM
Date -3d —D`7
i c Ward
Zoning District
Is Property Located In ,Location of
the Historic District? Ye—No !Wilding
Is POWSITY Located In
i the Correnrtlon Ares? Yee No_
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) R Install Siding, Construct Deck, Shed, pool,
epair/Replace. or:
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '.
The undersigned hereby applies for a permit to build accord~-19,to the following
specifications:
Owners Names��
Address & Phone 7gL/-3(//Z
04 Architect's Name
Address & Phone f
Mechanics Name pz'�f
Address & Phone tI
Wirt is the ptrpose of Wing?
Materiel of bWlding? N a dwaft for how many femaes?
WIN bAft conform to inw? A atos?
Edltnded cod Liciam r steer Licarre a /�y3
Seen LPtoeeneat
Lie. I 177 Y Sipatuna of Applicant
SIGNED UNDER THE PENALTY'
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
cz-
MAIL PERMIT
i
V
No. �� )
APPLICATION FOR
PERMT TO
LOCATION /
Cf c�otiroGjv 5
PERMIT GRANTED
19
AP OVfD
".
INSPECTOK OF BUILDINGS