HomeMy WebLinkAboutPermit Fence 1993-04-19\
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FENCE PER}IIT APPLICATION
CITY OF SPRINGFIBLD
BUILDING SAFETY DTVISION
225 North Fifth StreetSpringfield, Oregon 97471
Job Location:
Assessors P #:t
0ffi ce:
INSPECTION LINE:
Tax Lot *:
Phone #:
State:
Date
FOR OFFICE USE
Issued By:
726-3759
7 26-37 69
0vner:
Addres
Ci ty:
s:
Zi p:
Va1ue of Fence:Fence Permit is 95.00
Con t rac tor/fns taIler:
Address:Phone #:
Ci ty:S ta te:Zipz
By signing this
fence has been cthis application
Develop ment code
re
permit/apprication, r agree to calr for an inspection once myonstrueted (726-3769). r arso stated that alr information on/permit is correct and that r vas provided vith the springfieldrequirements for fence standards.
Date of Application:
Receipt #
Total Amount Collected:
CITY OF OREGON
Checked for Delinqueneies:
aa
Check.ed for llistorical. Status:
*:
Permit No
Address:
lssued
OR 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 f rom registration
under ORS 701.010(7), need not sudmit this btatement. Thii stateme-nt wil befiled with the permit.
Fill in the plicable blanks, and initial boxes 1 and 2, and either box 3A or 38
I own, reside in, or will reside in the completed structure.1
2 I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3.A My general contractor is_
Contractor registration numbe
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3.B ill 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 inlormation is correct and that I have read and understand
Da
the lnformat
reverse side
ion Notice to Property Owners about Construction R esponsibilities on the
is form.
ppl
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
Date
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT