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
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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
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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.
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CONSTRUCTION CONTRACTORS BOARD
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, \:. r PIIKCOPY TO APPLICANT
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