HomeMy WebLinkAboutPermit Fence 1990-07-31SPRIhIGFIELD
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDiNG SAFETY DIVISION
225 Flfth Street
Springfield, 0regon 97 477
Job Location:
Assessor M ap ll:
0wner:
Address:
C'ity :State:
Value of Fence:
Contractor/I nstal I er :
Address:
City:State:
Construction Contractors Registrat'ion ll:
a ur
FOR OFFICE USE
Date of Appf ication:
Offi ce :
INSPECTION LINE:
7 26-37 59
7 26-37 69
nl
Tax Lot ll:
Phone l/:
Fence Perm 'is $5.00
Phone /l:
Li p:1
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- --" zi p:
oires:(-^Ex
By s'ign'ing this permit/app1i cation, I agree to cal I for an inspection once my
fence has been constructed (726-3769). I also state that all informat'ion onthis appfication/permit is correct and that i was provided with the Springfield
Development Code requirements for fence standards.
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a e
b /l:
Receipt Jl:t,
Total Amount Collected:5
Checked for Del'inquenci es:
TccTJJ
Checked for Historical Status:
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By:
Permit No:
Address:
lssued
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the perrnit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 28
1.8 I own, reside in, or will reside in the completed structure
2.4 My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
,r) /
I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. lf I change my mind and -do hire.a qe.neral
contraCtor. I witt contract with a contrattor -who is registered w-ith the
Constructibn Contractors Board and I will immediately-notify the office
issuing this building permit of the name of the contractor.
B
I hereby certily that the above information is correct and that I have read and understand
the lnf6rmation Notice to Property Owners about Construction Responsibilities on the
reverse side ol this fo rN
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/-'/,-
m t t Date
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CONSTRUCTION CONTRACTORS BOARD
02MJ10l24lw
COPY TO ISSUING AGENCY PERMIT FILE
TO APPLICANT
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