HomeMy WebLinkAboutPermit Fence 1992-7-20
;:1
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
\ w I C -t"'Arl--eN\ V\ ','oJ
Assesso~p #: i 7 0 ~~2 [~ L[ y
Owner: J ~(' ~ \) (Ul5~ V\
Address: 17"'v 1 C ~vrt-1A1 Ifl:l' ~
Ci ty: S~'V)V\cj1 pJJ State:
I f . t<rV\t,
Va ue 0 Fence: 0l.A..J
Job Location:
Tax Lot #:
Lc?~OO
Phone #:
14~-(P1 V07
.
ziP:~7V7
()~
Fence Permit is $5.00
ContractorlInstaller: 'E=a/If~-f>_ (A-Vb
Address: ~l2-q N ({TV'- 5J-
~yrhPjf) ~/J
State:
012-
"1 L/ '14CJ
Phone #: '1L/J~ -5-33~
Zip: q1tJ11
Expires: g -Z-0-CfL
City:
Construction Contractors Registration #:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this application/permit is correct .and that I was provided with the Springfield
Development code requirements for fence standards.
~Q~ f4~
Signature /
7 ~ 20 r' 9"2...
Date
FOR OFFICE USE
Date of Application: 1 ""':ZD 4Z.....
go/OJ
,
Issued By:
JOB #: qzoqqV
~
Receipt #
Total Amount Collected:
5~60
Checked for Delinqupn~ies:
..//
Check.ed for Histodc<ll. Status: ,.............--