36 BUENA VISTA AVE - BPA-2006-978 AID APPROVED BY T44E
IW49=PBIOR TOA.PERWr AFMQ GRANTED
CITY OF_SALEM
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BUILDING PERMIT APPLICATION FOR:
Permit to:
(Ckcle whiclwvw apply) Roof. Reroof. Install SkWV, Construct Deck, Shed,(Pool,
RepawpAplace, Ofher
PLEASE RLL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS W PROCESSWG
TO THE INSPECTOR OF BUILDINGS:
The wWwa pned hereby applies for a permit to build according to the folbyiir►y
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Owrwea Name
Address a Pttone &)'w V; S/g (97�) ?el/3 X5-
Architeces Name
Address A Phone j t
Mechanics Name
Address A Phone f 1
mm is in puposs oI twYdrarl
ma"a OuYdYp4 II a meets,for taw mmy wn6n4
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Lie. / Soature of AWicant
SMED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT TO: e%� KRxzleYi/le `�l�vxay Si' /ems . oY ��1
NO. 7 ^G
APPLICATION FOR
PEMW TO
LOCATION
PERMIT GRANTED
2.0
INSPEQTOA OF BUILDINGS _.