13 MANNING ST - BUILDING INSPECTION gPtww Aw*Ef%AHw ND APPROVED t3Y im
INLRAClM PNOR TD A`FEBW REM GRANTkD
\� CITY OF SALEM
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Is GM LAcftdIn J Hof
ft mmft olll w Yes No
Is ft"my Loor.a in
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Permit to: BUILDWO PERWT APPL=TION FOR:
(Ckole whichewr apply) Roof. Retool, IWAN SW % CarN W Oeok, Sha Poo
AspaidRepleft Odw.
PLEASE FiLl Otrr LZOISLY A COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The u ff sip ri hereby applies to a permit to build acoor&-qto the.followkq
speaisoations:
Owner's Name
Address A Phone C, .v\v\ i , S f a7A7 e 1�2 3
Atohkect's Norma ( f G t a
Address A Phone ( 1
Mechanics Name _
Address A Phone ( 1
Whd is e■pupae 0 EuAdrp?
I1m"d wkw e a dwdkip,for how nrllly foniaa?�,
�_Gqr tioew r 8trrs uaww r
Lie. a awn a Applicant
t110NSD UNDER THE PENALTY'
DESCiMPT10N OF WORK TO K DONE oP PoutItY
1S L YZ 7P JO& Q1v1
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MAIL PERMIT TO:
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< ` MY OF SAIEM
BURBING DEPARTMEiT
HOMEOWNERI CEMSEF MOM014
Piemse Pdd
JW LOCATi0t1 13 1`��,� Y�
ADUMM
W.Wi Tf MALWO ADDRM S LLnn n
Tbc -.oampico d-immw roc+e wo s mrocrsomvk+dwal iv effm
Units a lm sad to allow rmh bommaw,�as to aq�arr bdivl&.* w bin vAm doa so pries.
Rowse,pw4Wcd tbat ie a vra+et ael 09 sspawleM
DEFDGTMOFHOIMEOWMM
Pasoo(s)wbo orrru a paccl d Lad oa wNeh hshbc raids a baeads ti residR o.wlWsh�ae k,4 r
invaded to be,s one b two Lmt dwcllfaL suadwd a dc- wucmu semom 10 ash m ardhr
farm sweaoee.A pen=who eomstrueu more I=cm b me br a twaFca icrW d as M he oo=Wkmd
s b=wowna. Swt 9wmeowue shau n bn&to the Burldb g OScbL m s b his
Bwldb�Odreid,tier bLWK be nsporalk to an rob wok pafamod
The u de sip W-bomww nc: awwm resporr%ft for c=Yr4m wi4r Codas ad
otha spp8obk`am by-kws,roles sod re=abtiea
Tbs=&nip w-hom ww•na-ecr35o to hehhe mdas n&the City of Saba.Bmildbr<Dgw=w t.
mmimmm vq=L n pm=dma and n gl&cmms ww that blsbc wW wmp1T with aid Moedas ad
HONSOV1 M'S SIGNATURE Q g'�
APPROVAL OF B=ING IIISPECTOR
$a other side for=a code
HOMEOWNER'S EXEMPTION
The code seta tart Cory boaeowim perforrabtj weds to vd id a baD&q posh is regabed M b
excup from gm p vv wss of ibis*cedes (Scales 16j.1.Y-Uceealsg of Cesattaetiom Esperibm
provided door is s bomwwsa wVgm.persco(s)for bbe to do.arrb wadr.tbo so&bo®eowa- do es
. as sspervtsat:'
MNq botueowm n w'bo we t a cmmpdas we im.waa tbrt they we mmuning dts vegomebMdei eta
ropwvnror(oee Appeedbr Q.Rula mad Jteprrbriat for 3focsotsg Caotnrctisu Egesvtosrse Eec7lon
.2.14 M brdr cf owareae I area tauhf In•criers problems.pertfe baV w'bm dK 6oneow—bbW
ttalbx9+eg pptsoma bn this can y=Bard aomtot promed&pim the mtlloe MA Pc*m m ltwonla w16
liaasod Sspmisor. 71s boteeow�cr sdtas so apcnloK r sgbo*s>e�'tsr
To esrtec that do homeowner Is tatty Wrote otbMa taponrlbl>Wesr mogr oommmdda teq�re;aapsrl
of the permit oppliodor,that the homeowaa mn*that bLWac wA nm b the respoetsbllMes ds
wpervbm You may can to amcad wd adopt such s*n UkUdliatiss fW toe is your oommml4'.