HomeMy WebLinkAboutPermit Fence 1992-2-14
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street.
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: \?Jri- \ J::n~m \.3\ ~~ (LOJ,)
Assessor~ap #: \, 03'2J~o3~. Tax Lot#: (Jl"l,OC)
Owner: '- ()'\\ \\ t Q ) " f)l~~ .' . ,
Address: n ~_f)~ 0'lill . . . Phone 1i:'l4~o-B2-'2B
City, ~1U f\f\<h &r6J st,,,, liJ A 0 or' . Z1P,G(l4 Tl
Value of Fence: dJ~OO . Fence Permit is $5.00
. contractorlInstaller:l~~
Address:
Phone #:
City:
State:
Zip:
Construction Contractors Registration R:
Expires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also state that all information on
this application/permit is correct and that I was provided with the Springfield
Development Code requirements for fence standards.
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Sign'atiIre -- ~
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. FOR OFFICE USE
Date of Application: r0, 14 ,'q ~ J ';Job R: e{GO l.:=s \
Receipt Ii: ,~f}4Z) Issued By:r-lj t[)() )
Tota 1 Amount Collected: h.CJ:J -
Checked for Delinquencies: )(..
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Checked for Historical Status:
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