HomeMy WebLinkAboutPermit Fence 1996-2-20
-.
._-,.
..:
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELQ
BUILDING SAFETY DIVISION
*
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
Job Location:
6 f7r1
,f,.,.s'\/~CA. ~~
gy' t; ~~;;; Dr
Tax Lot 1I:
Assessors Map 1I:
~U/.: (}~, 1I'//fJro,J/
Address: 5ti.J. ../~s. ICe... 1..fl,J1G.
Ci tY:~rl ~r;.;'e fdt
Value of Fence! I. :lOt)
Ovner:
Phone 1I:
)'1 I-orl (,
Zip: 1') '1)f?
State:
()r-
Fence Permit is $5.00
/
Contractor/Installer:
~ / "..1-1' t-
Address:
Phone 1I:
"
City:
State:
Zip:
Construction Contractors Registration 1I:
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 vas provided vith the Springfield
Development code requirements for fence standards.
Q:fI ,
/ ,~
Signatur '. r
;i6 oW /9~t:.
Date '
FOR OFFICE USE
Da te of
Application: 2/2 ~ 5".0
1I ? ~ ej.::2-+
Issued By: .
JO'~~'2-
Receipt
Total Amount Collected:
e;(pv
Checked for Delinquencies:
.....--
Checked for Historical Status: