HomeMy WebLinkAboutPermit Signage 1990-7-2
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: ~8f\ ~D~D ~.J
Assessors Map II:. \ fJ.D3 '3 <Q ~I
OwneA cJ\~~\\\ ~ \< ~ ~ ~k .
Address: ~\}.\ h{\.9..QJ\FbJ~ \:)'(" Phone 1I:14In,..lO\C:S~Q
City: ~~t\\ - State: C\hlJ ~\'\\'\ Zip: l\14-ll
V"" of 'eo,,, ql)()cD ,,," P,,,it i, $5.00 ~
Contractor/Installer: G\ Q 1\ I) ~\ llri .h IrO .
Address: 4W mn~o~. . .-p~one II: Il4l-44Joln
City: ~\Ci_ State: (QL..; Zip: Q'14l1
Construction Contractors Registrat.ion II:
Tax Lot II:
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Expires:
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.
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Signature \~{J
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. FOR OFFICE USE
Recei pt II:
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Issued By:
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Job II: tj()()t'-3B
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Date of Application:
1'l,I4D
Total Amount Collected:
Checked for Delinquencies:
Checked for Historical Status:
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