5 GABLES CIR - BUILDING PERMIT APP -N�61"T-BE fILA"W APPROVED BY T44E
JdBP.Ec=PRIOR TDA.PEPJ fT REING GRANTED
CITY OF SALEM
No. 3E 3 -61Z�? \ Date D �s
Is Property Located In Location of
Qre...brio obldct? Ye,No✓ Baildina
Is Property Located In
ft cwtomm on Ana? Yes.No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Hoof, Reroof, 1 S Construct Dank, Shed, Pool,
/Replace. er:
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 b Aar)gz L, Ne
Address & Phone S &AB L rS C 110Z Gf &7h `2,fT-aP9s
Architect's Name
Address & Phone / L
Mechanics Name 9'ra&w C Aft(gbAll�/ O S,0 /h0/9 f S0 5 60 - 2iuC
Address & Phone V2 eav sv s27� 1 7 yy-�aa
What a ttre purpow&bWldk►y? �.Si b/ub.3
MA"of brrlldbrp? n a OWN.for how rMny Iainillaa?
Will bu kkQ corrtorm to law? Ambeatos?
EatYnated era !1 a V CRY Lim"r 81016 1.1010 e e D k*-6 3-5
Brae Improvement
Lic. f /Vys- SfgWuri of cant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
,Z-itrStTi9ZG l//.t.y S//�/.c//Ls
5, 7ZP /?"45- Re'!VF
MAIL PERMIT
o 1976
No.
APPLICATION FOR
PE/R/yMT TO/
LOCATION
PERMITS GRANTED
' a
IVOd(/e— Zb
AP11,OV,D
INSPECT OF BUILDINGS
1
a •Z Y