14 COLUMBUS AVE - BUILDING PERMIT APP j
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JMP==PRIOR TO A PERMIT BEING GRANTED
CITY OF SALEM
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PermR to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Remcf, Install Siding, Construct Deck, Shed, Pool,
Rspai epla , other
PLEASE FILL OUT LEGIBLY 44 COMPLETELY TO AVOID DELAYS N PROCESSNG
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby applies for a permit to build accorft.to the following
specifications: //II
Owner's Name A nM y F1/E/2 t 7T
Address A Phone I Y C04-1,tM,e6.S Avg
Architect's Name �\ \
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Mechanics Name �ZUN CHHOCAy
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1� Signature of Applicant
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OF PERJURY
DESCRIPTION OF WORK TO BE DONE REP1,3CE -5-- 'V//vd /V/ows - o STeaC/Zr/2E CNg-"evc-
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