HomeMy WebLinkAboutPermit Fence 1993-3-11
--'.
...
..."
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Owner:
YS ,0 ~LL("^ Q&.
1 <Q n::t Os I:l..
I~(j,...p 110 o.
Tax Lot #: O"':\c:..rv"J
Job Location:
Assessors Map #:
()-~
A~dress: 4S /0 <Jo./\t)'^ Qd2
Ci ty:----.hp,/', 'nd. ,c-.:. ~ State:
...)
Value of Fence: .1iJ{')t"J6i1
Phone
# : 14 7 'JCr::Y::J
Zip: 9jLl75<
()Q
Fence Permit is $5.00
Contractor/Installer:
n l.^^ o..v-
Address:
Phone #:
City:
State:
Zip:
Construction Contractors Registration #:
Expires:
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.
i<&J
Signature
Ii, n il.-r-'
3/ II \~::>,
Date'
FOR OFFICE USE
Date of Application: ~/1I \q~
Receipt 11 1/5Ci
Issued By:
JOB 11: q~n~nJ
'6J~
Total Amount Collected: :u soo
/
Checked for Delinquencies: /
Checked for Historical Status:
/
u
V
L7