HomeMy WebLinkAboutPermit Fence 1990-7-31
~
._'.
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELO
BUILOING SAFETY DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: (071 I+A(<.lJ:)u..:J e..c:::.o
.Assessors Map II: 17-/"),-'Z..7, 'Z..Z-
Owner: /}.A. I Cl4-tl..E..L ? . EvAt-J. <::,.
Address: 107/ ~~,
Tax Lot II: ~ O()
City : ~:P~l "-.)(71=-1 8-1>
State: alL.
Phone II: 7Zb- ~S-Z.3
Zip:ll<}77
0-0_
Value of Fence: Zt:.DO Fence Permit is $5.00
Contractor /Ins ta 11 er: OfZ..E:LryuA.J 1=1: ruc..t=...
Address: Phone II:
City: S?I2..i~-,FIEL-b State: (:>~,
Construction Contractors Registration II: l \. \\(1../'7
Zip: q 14-(7
Expires:\ 12 - 0J-C\()
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
Development Code requirements for fence standards.
lM~ ~ f(/~
Signature
'L-'b\ -Q()
, Uate
, FOR OFF ICE USE
Date of APPlicatio~- ~\-C\C)
Receipt II: \ ~~ ct? Issued By:
Total Amount C:lle~ted: . ~. CC,)
Checked for Delinquencies: ~~cked for Historical Status:
Job II: c\(Y')Q(~q
~ ~~. - -
L