1 CABOT ST - BPA-2006-401 14s"61"T-SE~04019 APPROVE) BY T44E
JNSPECTLIB PRIGR TDA.PEAIfff IEING GRANTED
CITY OF SALEM
No. �/ \ ��
i"
Is Property Located in Location of ��Gi
Do Historic District? Yew No_ Building / l
Is Property L.ocWd In
are CanaarAign Arae? Yee_No_
BUILDWG PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, In"I Siding, Construct Deck. Shed, Pool,
Ralw/Fleplace, Other-
PLEASE FILL OUT LEGIBLY i COMPLETELY TO AVOID DELAYS W PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name 0-1 e Ij2
I
Address & P1 0 11 4 d 3 - 0?5 G
Architect's Name (V/)
.Address & Phone . IVA j 1
Mechanics Name n 5pe I ce ' w c
Address & Phone H F W-Cace- s+ 5x1e^ 4V (9a 1 ?kms_ 8 8 3'D
Wild is tiro purpose a Lxridkq?
MAN"d buidkq? B a dwaWrq,for how many IamWs?
WW 1m ikin conform to Iew? Asbestos?
EaimeW cod a ul 6-tom— CRY Lwow M IJ A MW Uoaw • „�� o S 4 sr}8
✓� Ba'e Lpra" t 1l )
Signator)J of Applicant
SKMED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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S: SAN rA.l t T J f7i bl tiG� J
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MAIL PERMIT TO: CASA sT,
CoQ-fes
No. D 'D
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
O4D
INSPECTOR OF BUILDINGS LL