112 BRIDGE ST - BUILDING INSPECTION �91�111W*Efk*44Wp APPROVED BY T*E
JUSPICM PW A?DA P.EBW AWa GRANTED
CITY OF_SALEM
No. 20 Z--,o \ ar Z os
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BUII am PERMIT APPLICATION POR:
Pannd to:
(Carole whiohow apply) Roof. Pawl In" Sid ft Cmuouot Dsoir. Shad, Paul.
Relow Rap" oawr:
Pi EASE FILL OUT LEGIBLY A COMPLETELY TO AVOID DELAYS W PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The wldsrsgrwd hereby appYss for a pound to build aoowft to the bl wmV
Owner's Nsltfe IW1 q-r- -4r LJ 6 2
Address & Phaw /l Z 1?1z 06t: 071
Ard*e is Narrw
Address & Phone _ f 1
Mwhanics Name
Address & Ptwm L 1
wlri�1ho prpooa ar ouiar�? Iti�a-r..,� ,
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SW= UNDER THE PENALTY
OFPWLILIRY
DESCRIPTION OF WOW TO BE DONE
ubl /yL Sr� K °, w QZQ (2CeLvev�1
MAIL PERMIT TO:
No. ��
APPLICATION FOR
PEW I TO
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LOCATION
P
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RMIT GRANTED
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