0002 FREDERICK STREET - BPA-06-278 RETAINING WALL 1
0
eHiST-eE f4l£G1idD APPROVED BY T*IE
W3P.ECJDR PFUDR TD.A_PERMIT BEING GRANTED
CITY OF SALEM
No _ a�� Date
Is Property Located in Location of
the Historic District? Yes_No_ Building 0- 2-
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: nk=7- a)/✓/ vc- u).4-LL
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 _f f 9l2 lylV' ?(OL1iti SSA
Address & Phone 7. FKi-h4A?1C � s j (ce70- It 03 76/
Architect's Name
Address & Phone ( )
Mechanics Name M A u n,c& )J-A7 r
p-0
Address & Phone 4 /-Fri nh/r n V AoX - Ft--7 -
What is the purpose of building? P t i A/4)i iv c: Lv h L V
Material of building? C-E N L- V? If a dwelling,for how many families?
Will building conform to law? Y &-5 Asbestos? IV 0
Estimated cost 2m a�u?City License # N A state License # 0 2 3 4 7 3
Horne Improvement V
Lac. ! to i 17 I/►, 'Sigifinatbrie of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE _
41,
MAIL PERMIT TO: dZW V
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No — \),)
V
APPLICATION FOR
PERMIT TO
n�2 �,' ? INo l r- •
LOCATION
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PERMIT GRANTED
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A�ROVfD
INSPECTOR OF BUILDINGS
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