13 FREEMAN RD - BUILDING INSPECTION (2) y� I
v II
l -DE TiL A4&PRO ED BY 144E
LW5PI:OTOR ,PFWR TLC)A PERMIT.B,FING GRANTED
CITY OF SALEM
No. � ..L# �.,�?� Date- �
Ward
NE� Zoning District
Is Property Located in Location of �'
the Historic District? Yes_No Building j IG,PY„,s, d
Is Property Located in
the Conservation Area? Yes No X
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed Pool,
Repair/Replace, Other:
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: I
Owner's Name 0VAj4kI A f kjoer l Eopl Pck.l
Address & Phone 3 f fe2l�1�FI�J �GUVi�R (q�b1 1� t� 1 3��3
Architect's Name S u S A
Address & Phone ( )
Mechanics Name
Address & Phone ( )
What is the purpose of building? �or Lawk) &,)o, pmeKA-, (;arcfefLnc► 1zu�is. �� c
Material of building? Ced a If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost 00 City License p State License >t
C�� Lie.
Improvement
Lic. / C � ,, �c�6)t 9(c
Y
Signature of App ' .,ant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
U SLEDS US�1
MAIL PERMIT TO: 7« ep Ay, ez
I
No. ` v
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
A P f ROVED
!NSPECTOEYOF BUILDINGS
C
afy OF SALEM
BUnDING DEPART AEM
I10MEOWNER LICENSE EMOM014
Pkase Pry
DATE Cod \ 1p 0 l ,� _
JOBLOCATION
mOMEOWM
ADDRESS
TELEPHOW
PRESENT MAII,WG ADDRESS
TM count c.Mdca of"ba neawt WC was cxmtdcd tv include owocr-oewpkd dwd0ep alTWO
� m adivid���"'l1O does aot poasmw tl
Units a kas and m allow such bomevNtkts � .
U=se,.prvvided dw the owner act as supmrrbw.
DEF24TIM OF HONMWNDL to reside.On VAM tram 1%a is
PcrwD(s)who awns s petal of Jard on whkh behhc ncsida m bucrds to we wdke
intended to tc,a arc to two SanJly dwtift shaded m dctsded sanctmrs web rase
tansideted
farm wucm cL A pawn wbo consrnras mops than me home in s two-? almod iM p
a bozowsa. Stilt lwmeovt=f shay subndt w the Building 015cia1.on a low stzspubk to 7k
Building 0MCi4"belshe be n spounbk to au sail►work p �tmda the building pal.
Tbc tmdeslgned'bomcowncr"sutures resporLnbtb�ty lm eomplttma wpit t!e Stay BnDdhtg Code tail •
otha applitabk goes by-lswt,roles sad tegulsDos L
Tat urrdcrsigard"hoveownd asses that hrlshe tmdcrswrds tie C'W of -
minimum Edon proccduau and ncgtnrcmcros and that 19shc will comply
HONZOWNEWS SIGNATURE `
APPROVAL OF BUILDING INSPECTOR
See otba sde fm stau code
r
HOMEOWNER'S EXEMPTION
The Code stela that: 'airy bomeowmr performing tvotlt for which a buDcffi g permit is ttxpbvd shah I*
ercmpt from tint p vs-'Alom of this section (Swim 2D9.21-Uassioi of Comructiou Soptrvisora
provided%bat is a homec"Ma cngagao a person(s)for hire to do.such wank%at siteh hom owaer shaD an
as supoybue
Marq bonwowma who use this cxtnWdm are G awam ea are the
A gals Ru Y g ? of
supaybow(sm ppe Q. la and Regulariow for Iletosiog Coostr wc&m Supervbotsr Secdn
.2.24 This lack cf swa wwa often rauhs in scriom problems•particvintr!y wbM tht bomevoaa bbo
miliaased pcnone In iMS case yom Board earunot proceed&ping tht wJkctmed pa on as k would v
licensed Su is c. The bomeonroyr satag as superviow ht otdsaat*tnEawPol{>r
To ensure that the homeowner is WV aware of bVt=respoanblthks.nmry exmtramdda tsgdm.as pap
of the pernal appliatioq that the bcmwwrna ccn*that InIshe urdonuWs the nsponsibnwa afS
supmism. You may can to wnrcod and adopt sulk a fotndc cntfuadm for mt is you eommugr•