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HomeMy WebLinkAboutPermit Fence 1991-10-1 . S~FIELD FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: 5/P{Po ~ Ss\-Y~ #.-8 Assessors Map #: 1<202- 0 ~ 1/ Tax Lot #: /J~ / /9 Owner: M,!i. \-\-~~ Value of Fence: Sd/YY\ Jl. ~~( ,fylc.L 45/4s:. State: Phone #: /j2-(p-qq-:z.:,o QV2- Zip: Q1J.{-1t5 Address: City: Fence Permit is $5.00 \ Contractor/Installer: ~Ll4- ~ &Yi'.~ Ao" 13t!J)< /a~3 J 'J?s - 772.~ Address: /Ei'~ 2 L~~v..-e L;.#" Phone #: '.3f< - ~6.2~ City: F..LJuCvc Stat~: ~ . Zip: 97~Cl/ . Construction Contractors Registration #: 4-CJb47 Expires: //2/92 f ' 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 Develo~ment Code requirements for fence standards. '7' /. .' ., ~ r L_ (J q I 7 / d' Signature / /()~/-9 / Uate . FOR OFF ICE USE Date of Application: 1& -/ -j I Job #: 91!.!..5" I Receipt #: 21 f~ 9!.. Issued By: .<~~ Total Amount Collected: ,C;:OO . Checked for Delinquencies: thecked for Historical Status: