16 JUNIPER AVE - BUILDING INSPECTION i 1
fL*NSfAbVT-6Efl' L APPROVED Sy 7414E
JMSPJE1.7JaR.PWR TD A PERMIT aVNR GRANTED
CITY OF_SALEM
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Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Sift, Construct De had, Pool,
Repair/Replace, Other. .1L
PLEASE FILL DWI`LEGIBLY i COMPLETELY TO AVOID DELAYS IN PROCESSWQ
TO THE INSPECTOR OF BUILDINGS: '•
The undersigned hereby applies for a permit to build accordwig•to the folbwkq
specifications:
Owners Name _ 1 -�Piatn �►�llPiyiNl4�ti
Address & Ph" 1 (or 'rJ�.(MA�.d
Archftect's Name ' /,V/l IGG r��, �A(i• �I
Address d Phone �//f (ry �N4��1TM � /� 1 q' ' 5�775t�
Mechanics Name Gl^Mf/✓ 1
Address 6 Phone
Whit is to pupm it huYdrg4
md"of tralldrrp4 n a drwarq,for how mmy wnem?
We hu0drq em"', to law?
Afeotos4 NO
Ettirutad oat JLl:L t1G Ctly Lkrrra r Beata r
gar Impsova t
Lie. ` s of t
THE PENALTY•
DESCRIPTION OF WORK TO BE DONE of /
( C
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MAIL PERMIT
No.��� - 5
APPLICATION FOR
PEFUM T/O/�/J,���
c4l, A,11 C]dV/-/11-�".�
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LOCATION
PERMIT GRANTED
19
APPRbI/FD 0
INSPECTOR M BUILDINGS
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DOPOBAL OF Dl BRX APPMAVrr
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CrrY OF SA1EM
BUUMING DEPARTMM
HONEOWNEil LICENSE E)OR O N
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DEFOGTENCFHCMEOWNM
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HONMVIM*S SIGNATURE
L/
APPROVAL OF BUIIDING ME
Sec mba side for mu code
HOMEOWNER'S EXEMYnON
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cmupt from the prwwom of ibb seetiso (Seedw 11paa-33oeasias of eooanwam Sapavbwo
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supavisor(see Appeadis Q.Awks sod Resubtbas tea Uccostos Ceoantedoa Supenboes.seedea
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To crime tfm da homcOwna b!ally awme of hllba repoaeibl>dds-mmq aomam¢ties tarplra:w pat
cf ds pamii sppliea lm that the bcmwwna ca ft do bLWw mrdersauda the respwwbnMw sf a
supavbm You mq care to wnead and adopt sam a t wmkcnVodm tbtr an is poor coon ms4.