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HomeMy WebLinkAboutPermit Fence 1990-03-05FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION State: SPRTI{GFIELO Offi ce: INSPECTION LINE: 225 Fifth StreetSpringfield, 0regon 97 477 Job Location: Assessors Map #: 0wner: Address: City: Value of Fence: Contractor/I ns tal I er : Address: ffi 726-3759 726-3769 Tax Lot #: Phone #: Fence Permit is $5.00 Zi p:Iu) Phone #: C'ity :State:<-^Z1 p: Construction Contractors Registration #:(- Ex pires: By s'igning. this permit/appligq!i9!r l agree-to call for an 'inspection once myfence has been constructed (726-3769). I also state that all information on-this-appfication/permit is correct and that I was provided with the Springfie'ld Development Code requirements for fence standards. T: a*t e 139agna-ry FOR OFFICE USE Date of Appl i cat'ion :Job #: Receipt #: Total Amount Collected:5 Issqed By:@ CITY OF OREGO'V Checked f or Del 'inquenci es :Checked for H'istorical Status I l/ Permit No: Address: lssued Date: 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 permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 28: 1. f\-] I own, reside in, or will reside in the completed structure. 2. A. f-l 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 qmatil t&I#Fcopy ro rssurNc AcENcy pERMrr F'LE B I will be my own general contractor. lf I hire subcontractors. I will hire onlv subcontractors reqistered with the Construction Contractors Board. lf I chanoe my mind and do hire a general contractor. lwill contract with a contrabtor'who is reoistered w-lth the Constructibn Contractors Board and I will immediately-notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the lnlormation Notice to Property Owners about Construction Responsibilities on the reverse side of this lorm. cant CONSTRUCTION CONTRACTORS BOARD v24) 10t24t8p te , \:. r PIIKCOPY TO APPLICANT \-,L-r Y1'.{Q_2 @s 2,(Lt--l )