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3 CYPRESS ST - BUILDING PERMIT APP
1*t6T-BEfiL{-#?1ND.APPROVED BY T44E SpBCTQJ ,PRWR TO A ERMIT BEING GRANTED CITY OF SALEM � . � .o3" No. I429 -ZPOLI ,'� `t� Date •,aVI, t.i i1a Is Property Located in I ocation of the Historic District? Yes_No Az Building Is Property Located in the Conservation Area? Yes_No . % BUILDING PERMIT APPLICATION FOR: . Permit to: (Circle whichever apply) Roof, Reroof, IqStatLSiding, Construct Deck, Shed, Pool, Repair/Replace Other Si' 6b( I fnlmA 54Dye— 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: Owner's Name Lt5k-rL J• C%1 I) tafzen blusw - S-vi Ill-) Address & Phone rA A VV j[ SS �sl� r 9 �1 � 10&4 Architect's Name r 'j ."A — l G� i /c— Address & Phone 1 ? f-o �rCJ ( � /� '7 MI - Address " 2L6L`-^C Mechanics Name E Address & Phone 1 What is the purpose of building? TAU P—I I 1 Material of building? t' ocb If a dwelling, for how many families? ©ry, Will building conform to law? Asbestos? W Estimated c///o��1st 350D 00 City License# N State License # � Improvement X Signature of Applicant SIGNED UNDER THE PENALTY OF PERJURY • DESCRIPTION OF WORK TO BE DONEE e �f � va . . U, L _ ° Qrdrr4 Zn1�101 �, .a1� paSYN� ate, -I�� .�,bt,�. C�h.h��z -Fa J�(, •�(e�- S��,c�rS MAIL PERMIT TO: s � 1vQo ar re z o LL l� J © Z LLI ` m at Q LL VI ¢ p ¢ ,O a W O_ 0 U... O + as - O CE z° a ¢ Z