130 BRIDGE ST - BUILDING INSPECTION r
1WS7 13E APPRO GL BY T44E
J MC=PRIQR TD A.PERMR RMG GRANTED
{\ CITY OF_SALEM
No.� )
Date
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- Zodng Distncf
ItM HWaric Diddd?„ Yes No a� Locative of
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Is PfWerty Locded in
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the C 86madon Ana? Yak_No a�
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace. Other. f59-th E&6e24
PLEASE FILL OUT LEGIBLY A COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '•
The undersigned hereby applies for a permit to build accordkig,to the following
specifications:
Owner's Name k!/C r e,&
Address A Phone /?g)A ilx�'e_ /' S4m Q24 a)7cG11-/(4Ps
Architect's Name n ice(
Address & Phone If I
Mechanics Name
Address A Phone f 1
Whet Is e»purpose of EukW
fdandal a WNdrtp? N a dwaft .for how many famaes?T
WIN h dam conform to law? I eS AMNMs? j"j U
Etanatted cost 0 0 CRY Llcarre a saete N
Ue t
> S' of Applicant
SIGNED UNDER THE PENALTY'
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
��A 3A-�1 P-0 6 rn��-tv r l e-tr-
MAIL PERMIT TO:
E
APPLICATION FOR
PERWr TO
LOCATION
jL
PERMIT GRANTED
19
APPRO
7
INSPECTOR OF ILDING