29 BUCHANAN RD - BPA-2005-167 � ss
fL�INBiMtl6T�EflLf9gIND APPROVED BY TWE
ASPEC=1 POW TD A PERMIT BEING GRANTED
CITY OF_SALEM
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Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other Acura L c rn b,X,
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '.
The undersigned hereby applies for a permit to build accorckig.to the following
specifications:
Owner's Name 14&, lt1w4z5-ev ivy
Address & Phone 7-1 gvGh5 mli /l W7-1 ) 7Yy k24
Architect's Name
Address & Phone ( 1
Mechanics Name /7kSScry QAV,
Address & Phone IVY fTEr-Kov flva ,arys� �r� I Sys 21�0
What Is the pirpoee cf txdldkg?
mftw of hk~ ivoyn w/ / oti f%G. n a dweWng,for how mmy faMon? /
WIN bAdlnp conform to low? YES Aabeetos? F��A
Eslmatad cost /S k CNy Ucerae N state Ucarlse e C5 060 yy?
aa.e Improvement
Lit. IF Z Z—& LL r(
Signature of Appli ant
SIGNED UNDER THE PENALTY,
OF PERJURY
DESCRIPTION OF WORK TO BE DONE MAIL PERMIT TO: M,0S&Y 621 rlWcRr ✓ GoRp MI/ i7e7rro v f&,e- Sw�4117-
•
No. LX
APPLICATION FOR
PERT T TO
I'P h,nA
LOCATION .
of &,-
PERMIT GRANTED
AP ovFD
i
INSPECTOR13F UILDINGS
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