26 HARDY ST - BUILDING INSPECTION I
fL1kNEiM1>76T�E fKg94AD APPROVED BY T44E
,P1310A TD.A.PEAMIT BEING GRANTED
CITY OF SALEM
is Propeny Located in Location of
the HhAoric Dlsid d? Yee No Building
is Property Located in
Me Cornewatlon Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, hed Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY 6 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
Address & Phone 4o
Architect's Name
Address & Phone )
Mechanics Name
Address & Phone p f )
What is the prupose of buNdbg9 ra,LiL
MalarW of bulidtrq? w=1 N a d**Nft,for how many famMies?
wMl bulldUrq cordorm to law? AsbeatW?
Eafinuded coat /a�On`0 City Ucer"e N A Lim"a
� 6 Lie.Home Iaprovsent
l/./ Ignature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
o X ►s (,ADO kW6( 6L GP W-2-1 61ILS
MAIL PERMIT TO:
C .
2
1 '
1
No.,
APPLICATION FOR
PERMIT TO
1
LOCATION }
PERMIT GRANTED
2.0
AP R VFD
INSPECTOR OF BUILDINGS
I