29 CHESTNUT ST - BUILDING PERMIT APP 1A 3 fl;
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
BuAdiog Permit Application For Loeadon of Building �� GL557=1f- S�
'(Circle whichever applies) Roof, Reroof, Install Siding Construct Dick, Shod, pool '
Addition, Alteration Repatr/Rcplece,Fougdaoq prjly, W
Other:
PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inapecwr of Buildings: '
The undersigned hereby applies for a permit to build according to the following specifications:
Owners Name: m°G N Contractor. P< ,& -f-
Struts c/ G/1' S {,u,At City f ( Streetlo uml City t lc
State- p{ phone (9n)_2 Yi Sa 4o state 1 Phone(7,4/)
AmWam: City of Salem'Lkk
Strut Ciq State I"I omp s 4f d�oZ�
State Phone ( ) liomeowseri Exempt Form —yea no
Structure: (please d de) Ingle Famil Multi Family# �Other
Estiotted Cost of job t C�2 � I�7� 6
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Will buiilydleg eounnoo�tool law?
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Dnwiogs Submitted:___ya ono Mail Permit to:er g G
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Si re of Ap G D UNDER THE PENALTY OF PERJURY
CONSTRUCTION Tn BrurnmanLETED WITHIN SIX MONTUS OF PERMIT ISSUED DATE
Department use only: permto zoning
Permit foe S
comet TS: