0006 LORING HILLS AVENUE - BPA-06-135 10.2L
APPLICATION FOR
PERMT TO
!/LOCATION '° ✓✓
PERMIT GRANTED
19
7VFD
INSPECTOR OF BUILDINGS
t
gPb%M111WISEf*L9$4ND APPROVED BY T44E
WPF.C1QB PWR W A PERMIT WMG GRANTED
CITY OF_SALEM //yy
No.
1 l� Wwd
Is Pfowly Loom Lm
MeI kkxic DNMd?in Via Np mail"oo of
��i
Is Plowty Loomd in
.- tw CWWWV&lom Ma? Yes No
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof Renoof, stall Sidi Construct Deck, Shed, Pool,
iNReplaoe, or..
PLEASE FILL OUT LEGIBLY i COMPLETELY TO AVOID DELAYS IN PROCESSM
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby applies for a permit to build accord4ig.to the following
spoons:
Owner's Name
Address A Phan
Architect's Name
Address 6 Phan
Mechanics Name Z1 N,
Address & Phone �(S (2(a�1L /�✓.,. L y�5_(�
Whet a m.prpoo a twrarq?� P aP/��G �Ki kP�e�P �Pe<
t"trt a tr~ r' q s dw.wq,for tow nlafly hnMNs? S
wa to kvww? 7Ps Acb rV11���
Ewnwd cat �nr? _Cry tJe r U r (.f3
n of A001ftnt
UNDER THE PENALTY'
DESCRIPTION OF WORK TO BE DONE of PERJURY
,PPJ�/�nN. �i�TiCo 1/�1 1d1( 4' &CI
MAIL PERMIT TO: