HomeMy WebLinkAboutPermit Fence 1991-7-30
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SPRINGFIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
Job Location: <)"77.2 K.4LN/A- L.t!
Assessors M~P #:~~~~\ ~
Owner: ,/) E A-.fI/ (';< (j /JIl,.<?O I
Address:.S'77Z KAb-</Q. L,;J
City:~ \L;'rl'I1I9-f!:;'J'.do State:
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J. 00
Value of Fence: -#> jqZZ;-'-- Fence Permit is $5.00 ~
ContractorlInstaller: Mi?tJ0eX2 k..;-.;(!e Co ~
Address: f{') .,8'0 ~ } 6. r- Phone #:9.-:::J7~-;a9~
City: t!.,O weL-L State: ~ OJQ Zip: 97L/52...
Construction Contractors Registration #: 7~()<o2 EXPires:~~1h.?
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
~ <;^'~ (')~ 97~?/f
Tax Lot #: ("EJ).f()
Phone #:
7~/,..g-3A 5
Zip: 97<::/7e
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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 a lication/permit is correct and that I was provided with the Springfield
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ignature Uate .
. Date of Application: _.1/J.f:J/7'1
Receipt #: ~5 ~ Issued By:
Kg..
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Total Amount Collected:
Checked for Delinquencies:
Job #: 7'11'?~5'~
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Checked for Historical Status:
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