HomeMy WebLinkAboutPermit Fence 1992-2-4
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELO
BUILDING SAFETY DIVISION
225 Fifth Street.
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769'
Job Location: . \:) \' .. \\,{\if\ 'aITQO t
Assessors Map U: 110'33'5 3cQ " Tax. LotU:~qro) , )
owner:~\."')\ \\1) 'ffi~~ ?\\~\\~-O' \\.1\\\\Q.G~~: "'T'illJJ'Qu
Address: \ ~ \ '\'f'f\ \. f\ ~ ',' Phone U: '14 \ ~ ~
CitY'~~ 11. cD st""Jl)n Oxm.LZfp,!1JfIj
Value of Fence;~ ~l)('); .,'.' . Fence Permit is $5.,00' "
Contractor/Instal1er: ~()\ \0,1) It. ,~QJ\(\~./ . '
A~dr~ss:O() ~ \C )f.28'~ " Phone #:~:-,:!(Pff>
C,ty.rJ.. X)~) State.~., Z'p. Y tftt)
Construction conGactors RegistrationH: 4!1( n4 fl Expires: I. j:)., ,q '3
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! was provided with the Springfield
Development Code requirements fDr fence standards.
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Signature f"
':-Y-f?~
Uate
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*
'. FOR OFF ICE USE
Date of Application: c!) .4, qQ. ,_/Job II: C:~l'A.c)\~
Receipt U: "OXoCfJ ISCij: t::1) If'{) ):
Total Amount Collected: O. .........
Checked for Oelinquencies: ~ Checked for .Historical Status: ~
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