HomeMy WebLinkAboutBusiness License License 1994-5-19
/ AtARK ~YSTEH PERMIT - $40 FEE
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CITY OF SPRINGFIELD
DEVELOPMENT SERVICES
225 FIFTH STREET
SPRINGFIELD OR 97477
City:
State:
Zip:
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DATE:
" - t 1 - 94
IS THE ALARM SYSTEM BEING INSTALLED AT A RESIDENTIAL OR BUSINESS
LOCATION?
RESIDENTIAL
BUSINESS ' i.
If a residentially installed system, please complete questions
1 through 6. If the system is being installed at a business
location, please complete questions 7 through 13.
1. Name:
2. Address:
3. Phone Number:
4. Date of Birth:
5. Is the system being installed by the homeowner? Yes
No X
If no, then indicate the company that will be installing the alarm
system:
jOIlJ,T40,-
o. Date of installation:
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7.
Business name (only if system was installed in business):
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own'er Name: .s lA. t3
8.
9. Owner date of birth: 19;t~
10. Business address: 2 2.~ J&lo~nt t}
City: ~f'<I;"h[.dJ State: ()fl-
11. Phone Number: 7c1tr i'l~ /
12. Company that installed alarm system: , ~6AJ tr(Ol, -. )IL'Nr
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;3. Date of installation:.J.....Z/, ,f,y
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Zip: Q7"11"7
ELECTRICAL PERMIT-REQUIRED
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