444 HIGHLAND AVE - BUILDING INSPECTION (3) ' t
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APPLICATION FOR
PERMT TO
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PERMITRANTED
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INSPECTOR OF BUILDINGS
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OPUMNSMIWIDEfNA94AD APPROVED BY T44E
AMPACM8 PWR W A PERMIT AEWG GRANTED
CITY OF SALEM �� �
No. Q\1161
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Permit to:
BUILDING PERMIT APPLICATION FOR: �u
(Clyde whichever apply) Roof, Remof. Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other•.
PLEASE FILL OUT LEGIBLY i COMPLETELY TO AVOID DELAYS W PROCESSING
TO THE INSPECTOR OF BUILDINGS: '•
The hereby applies for a permit to build a=rd4-q,to the foam"
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Owners Name _Pi d—A J A bs—i Taff
Address 6 Phone 3'7 W�n` &j� chit. L k!P (ft) +79 W:7
Architect's Name
Address A Phone ( 1
Mechanics Name
Address a Phone ( 1
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UNDER THEr PENALTY'
DESCRIPTION OF WORK TO BE DONE of PERJURY
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MAIL PERMIT TO: