35 MARCH ST - BUILDING INSPECTION TAU
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building dnc���tar�
Building PermitrApplication For:
'(Circle whichever applies) Roof, Reroof, Install Siding, Construct Deck(jj;�Pool
Addition, Alteration, Repair/Replace, Foundation Only, Wrecking
Other. ,
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector of Bui)dings:
The undersigned hereby applies for a permit to build according to the following specifications:
Owners Name: �b 9- 1�a c..e 44 Contractor.
Street 35 MAvri" Ciq \ Street City
Stawy'm Phone r\y�k-SpNP4 State Phone( )
Architect: City of Salem Licit
Street City State Lid HIP#
State Phone ( ) Homeowners Exempt Form___yes no
Structure: (please circle Single Famil Multi Family 8 Other
Estimated Cost of job$ \ool'�
Will building confirm too yes no
Asbestos?_Y es 1" no
Description of work to be dome: ( reck ag,"-e .
Drawings Submitted:_des (--�no Mail Permit to:
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SagdAure of ApplicatiodSIGKED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO Bl�COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE
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Department use o y; emti 'll`LN)—`Z ning MaplLot
Permit fee
COHMMS:
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HOi�OWNFA'S SIGNATIA(E
APPROVAL OF BtJIIDZNG WSPEC70lt
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MY OF SALEM
MMING MARIMM
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HOWOWNER'S SIGNATURE --
APPROVAL OF B=ING
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