9 GABLES CIR - BUILDING PERMIT APP r.
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Pi 11 11111 IN . VIED BY TW
SING GRANTED p
CITY OF SALEM
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BUILDING PERMIT APPLICATM FOR:
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(Ckdo whlohewr apply) Raof. RKWo In" Siding, Co NWW.D" Shad,
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PLEASE FILL OUT LEGIBLY A COMPLETELY TO AVOID DELAYS IN PROIIBBIIIIIIIIII
TO THE INSPECTOR OF BUILDING&
The underalrood hereby apples for a pwmk to bold aaeom" to the fokewirq
Owwes Name f1 13 A r-) 3-6 Y Dl4 I Gl
Add:ws & Phae. G�:b✓3 k 9 S C 12 CL-f 0' j 7 v s- S.s`0 7
Amhkwft Name
Address & Phone ( 1
Meohanbs Name
Address A Phone
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SIQNF,D UNDER THE
OF PERJURY
DESCiEPTION OF WORK TO BE DONE
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MAIL PEflMR TO: P rl r
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