38 CALUMET ST - BPA-15-566 a
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13E f fllz-E fJD APPROVED By T*IE
,W5P,XT,DR ,PRWR T-O.A..PERMIT .BENG GRANTED
CITY OF SALEM
,,111I �i T\
I. AL V V�' Date
Is Property Located In Location of .� /�Q L
the Historic District? Yes_No_ Building ( 4 m-o'T
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications: n
Owner's Name I�c��� SA VA
Address & Phone 3 8 (� 41 u M -p (. S ( ) - I L( Z R b 3
Architect's Name .Pis/ Cf 6,).y Ct A-A 7-
Address & Phone ( � /h.41 ti &T T PAbaoy 67S S 3 1 g Z 3 V
Mechanics Name ( 9� 0 4
Address & Phone [� ( )
What is the purpose of building? �� r t G , o F-l- e R E)
Material of building? If a dwelling, for how many families? _
Will building conform to law? Asbestos?
s2T
Estlmated cost Q 00 o(D City License # N A State License # ((9
Home Improvement � cam^
Lie. i OD
Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
S l Q'r b � 00IF �-� �oc�7
MAIL PERMIT TO:
'�� bCD 0
No.��
APPLICATION FOR
PERMIT TO
LOCATION:
PERMIT GRANTED
VFD
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INSPECTO OF BUILDINGS
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