HomeMy WebLinkAboutPermit Fence 1994-04-26225 North Fifth StreetSpringfield, Oregon 97477
rENCE PERUIT APPLICATION
CITY OF SPRTNGFIBLD
BUILDTNG SAFETY DIVISION
SPNINGFIELO
0ffice:
INSPECTION LINE:
726-3759
726-3769
Job Location:
Assessors Map #, [J oZVl I
0wner:
Address:
Ci ty:
Value of Fence:ff1 Dn9-
Con traetor/Ins taIIer :
Tax Lot {t:6tqm
Sts
q
5i-Phone #:
state, DfL
Fence Permit is 95.00
zip:a
Address:
Ci ty:
Phone *:
zi p!
eonstruction Contractors Registration #:Expires:
Da te
FOR OFFTCE U SE
Date of Application:JOB #:14
Receipt lt qu Issued By:
TotaI Amount ColIected:
State:
By signing this permit/applicatiglr r agree to calr for an inspection once myfence has been construct"a (zzo-glog>. "r arso statea that all information onthis apprication/permit is correct and that r vas provided with the springfieldDevelopment code requlrements for fence ,i"nJ"rar.
u
Clrecked for Delinqueneies: L/Checked for Historieal Starrrs, /-
Permit No
lssued by
R 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 tosign the following statement before the building permit can be issued. This state-ment is required for residential building, elecirical, mechanical, and plumbingpermits. Licensed Architect and Engineer applicants, exempt from registrationunder ORS 701.010(7), need not sudmit tnis btatement. This statement wiil befiled 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 soldor offered for sale before or upon completion.
Contractor registration numbe
1
2
Address: ,Lm N 7qfi'\r
e,r.,,q-Date: Wg
I will instru.ct my general contractor that all subcontractors who work on the struc-ture must be registered with the construction contractors Board.
OR
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 nire"a general contractor, I willcontract with a contractor who.is iegisiered with the Con.trr-i.ilon contractors Boardand I will immediatery notify the ofiice issuing thls;;iili;; permit of the name ofthe contractor.
I hereby certify that the above inform-ation is correct and that I have read and understand
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of can
g^O.ry gTB UCION CONTRACTORS BOARDo244J 8t91
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