13 LAWRENCE ST - BUILDING INSPECTION (2) QS-M ST-BEfiL� APPROVED By TIE
LN3PXTDFI ,PWR TD A.pEAM1T B,EWG GRANTED
CITY OF SALEM
� — a
No. �' J .` r Date
\"�trmneoa'�}
Is Property Located in / Location of
the Historic District? Yes_No ✓ Building ' 13 L-aw(Ence 5{
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other: /UnMNnxe.
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 rt'C-knGf-) + 1-7aL1, r MDq 1 Cl U+
Address & Phone t3 Lccu- enu, 6� (9-1g)
Architect's Name n/A
Address & Phone ( )
Mechanics Name t)/a 4
Address & Phone n� ' L )
What is the purpose of building? V N�5 tt N r? vn bo cyr rn n-�
Material of building? 6J&Z7 If a dwelling, for how many families? Jt ne IC- tm 1 Iy
Will building conform to law? T Asbestos? �a
Estimated cost City License# N A State License #
046 -� How Improvement v
�CaR Lic. I ,A,
gkdw
Si nature Applic
� 4 SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: Lr/ Lu S ,r FI i zabe�h M(q i n4
13 LG-wre ce- �
fo_ICM , Mft 01a-70
J
4
l
v No.ls�
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
APPRO/VFD
INSPECTOR OF B ILDINGS
CTPY OF SALEM
Bunmu;G DEPARTMW
iimaowmuaNSEEXFwnom
Pkase?tY '
)0l1ACATION
La W- r-cn ccL100
5 5a[erg^
•xo
Tames I ^. •
MMSbrrMAU.WoADDRtli=
7ha emreat.00 m1�1�a(-homeowme way cum"a hr lade ew.er•CmP�dwsl�i0 a[T1N0
Va4s a ks and a Blow aed�lomeowaas to en�a{s m .�h8o wdm doer aet port• .
�ioCaae,pevided dntie asner'ast d�
DEF4'It rm a} Ot M m which hahhc resides a hMoids to reside.on w�3 dMss:1%R If
Palm(s)w w two a pved >o eMJ srrc andYs
Wended a W,a cm m nw�dwdit.saadad a&ad"R,W, 0 aolM s w11 AftO
i m swocw .A penm who wrAvvm moot=me boss,IRS two•yar p'�
a bom wwmt Sv*—nmwowmf abal aabndt to the DWWb{O91IC14 oo a hM tots
By;�Oaidd,dm bslthe be reaponsibie to all snd►wak pafamad,odes dno pass
a m,daslp W-homeonncr ammMa"aponsbMrJ!or eomplioroe"�" Stare BoCdSaS Code a�/
otha appliobk Sm%-kwa,riles and Tgobdu L
The,mdaslpMd-mmcow� =rdda*at he/she=das+sns the C'W oil Seksa Bt+ildb{Depesaaatl,
minimroo> FUWX ea and rq*emaats and rlrt hhhe Comps wI11 praCedmoa ad
regdreadL
HOMEOWNER'S SIGNATURE l
APPROVAL OF BVIIAAIG
Sac aba side is state Code
HOMEOWNER'S EXEMPTION
The cods sues tbrc •wq bmwm3m,pafambu wpd<for wW&a bWW4 pamb b MqAW dol M
excmpl fmm the povW=of thb aecdm (Scabs 71P.0-lJusft d comracdw Upa o wed;
Prwleed that b a ho®eorna mpio!persos(s)fss hbs to do.puch thst sirc4 homwowaer drill aat
mwW bomww==wbo we dds cmmpdoo we imrware to*Ay ae awmdod dos pgomsdddei mh .
supavism(pee Appeodb Qs Ruin amd Re=ularbm for Lioroslng Cmarwcdom Euperv%n%=sda
.3.30} 7bb Imb dowau o mica ranlu im aeriart problems pedeoler�w hm 64 howeowaa ht�it
W&USod posomt loth owe yam Eomd am of proaecd sjabai the tm>loeawe pegoa n Itwpda w�
ikcared Sopavisgr. 71e lomcrwva aalog as wgorvb.w b■Mfwse rsrjpwM� ,
To eases that dK lwmeowaa is fdty owe ctbAw.re V=sIbMdmN*amr4 eomeemdda te4io;m papl
of low permii appAodom,drat*abcmaoraa caft dm bchbe mdersaa 1 the rnpoomhmn are
snpavbm You mq cm to amead nd adop subb s hnw a M=das dos sme im yom eommmiig6