HomeMy WebLinkAboutPermit Fence 2002-09-22225 North Fifth Street
Springfield, 0regon 97477
FENCE PERHIT APPLICATION
CTTY OF SPRINGFIETD
BUILDING SAFETY DIVISION
SiPIIIilGFIELD
Office:
INSPECTION LINE:
726-3759
7 26-31 69
CITY OF SPR OREGO'V
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Job Location:
Assessors Map #:l1 jD43 Tax Lot *:
Ovner:
Address:. Phone #:
Ci ty:State:Zip:
Value of Fence:Fence Permit is $5.00
Con t rac tor/Ins tall-er :
Phone *:
Ci ty:State:zip:
Construction Contractors Registration #: Expires:
By signing this perm
fence has been const
this application/pen
Development code req
itlapplication, I agree to call for an inspection once myrtrcted (726-3769>. r arso stated that alr information ont is correct and that I vas provided vith the SpringfieJcl
re s for fence standards.
Da te
FOR OFFTCE USE
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Issued By:
gna ture
Date of Application:
Receipt #
TotaI Amonnt CoIlected:
Checked f or Delinquenei e.s:
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Checked for Historiea l. Starrrs:
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Address:
1
2
Permit No
Address:
lssued Date
OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. 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 boxes 1 and 2, and either box 3A or 38:
I own, reside in, or will reside in the completed structure.
I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
A My general contractor is ,
Contractor registration num
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
3.8 I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. lf I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction 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 info n is correct and that I have read and understand
the lnlormation Notice to Property about Construction Responsibilities on the
reverse side of this form
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CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
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WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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