8 ESSEX ST - BUILDING PERMIT APP n
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fl�IN61"TINEfNA94AD Aff"OVED BY T4W
JdSP1CT0 PSIGR TDA.PE"T AFJNG GRANTED
CITY OF SALEM
No.
Ap r
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Looatioo of
Di X
ft FYdaic MAct7� Y_ No� �ri7/iat
It Pmpaty Lonled In
the C,a unp0m Am? Yst_No_
BUILDING PERWT APPLICATION FOR.
Permu to:
(Circle whichever apply) Root, RerOot, I Construct DWK Shed, Pool.
RepaiNReplace, O�'^r a
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS W PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build acoording to the following
specklicabons.
Owners Name Co I N r✓ k,'�C r x/ w
Address& Phone 8 tL�.S CK_
ArchdWs Name
Address & Phone 1 1
Mechanics Name
Address & Phone BV�r]W l r_t"n�� ( )
Whet Is fw pwpm d WNW lV4 V n, jz�F 1 e—e
mom of W? R-1 r t- c d l✓Ar"> a s dw@&V.for how many f mfts4 T
wo wiq=do=to low? e S Asb ? IIrO
t;dmased cost , _CRY umm r N A a m um"r
asses Lwro. t X
ias. a l3 434s Signature 61 Ak*ciknt
SIGNED UNDER THE PENALTY
OF PERJURY
DEESCRWrION OF WORK TO BE DONE
vi� ��i�s� �Y � rrvY 'T,'L� •� C��,��i
MAILPERMITTO: X1411ell 4HI /tt /l/9 d/add
No.
APPLICATION FOR
PEFOW TO
LOCATION
PERMIT-GRANTED -
L b
INSPECTOR'OF BUILDINGS