HomeMy WebLinkAboutPermit Fence 1992-03-17CITY OF SPR'A'GFIELD, OFEGO'V
225 North Fifth Street
Springfield, Oregon 97477
FENCE PBRHIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRII.GFIELO
0f f ice:
INSPECTION LINE:
726-3759
726-3769
Job Location:/l{o /oW ,W-r/
Assessors Map #: I >
SAr/",
rax Lot *: @ fl&
Ovner:
Phone *, ?V(r'4aZl
,E 2? 7?
Address:
Cl ty State , 0,b Zip
Value of Fence:Sfu bL
Fence Permit is $5.00
Con t rac tor/Ins taller :[t^iv\SrV''
Address:Phone *:
Ci ty:State:Zip:
Construction Contractors Registration *:Expi res :
--
By signing this permit/application, I agree to call for an inspection once my
fence has been constmcted (72613769). I also stated that all information on
this application/permit is correct and that I vas provided vith the Springfield
Development code requirements for fence standards.
S*^ \.-N-j-11^92
Date
FOR OFFICE USE
Date of Applicatio", 7' I*7 -? Z-JOB *:
Receipt #Issued By:fi,w..,.--l
Total Amount CoIlected:,4 o.d?)
Checked f or Delinquene'ies:'/- check.ed for Historieal Status . --.
4.??za
Permit No:
Address:
STATEMENT:
INFORMATION NOTICE TO PR
lssued
OPERTY OWN ERS
Date:
R OFFICE USE ONLY
ABOUT CO NSTRUCTION R ESPONSTBILTTI ES
Note: oregon L"y,_grs 701..055(4),. requires residentiar^construction permitappticants who are not registeL,i iritn ih" c;;i;JJiio, contractors Board tosisn the forrowino,sl"t"rgii-oJiJ[ i19 oi,iioi.i p"'ril]i.", be issued. This state_
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licabre branks, and initiar boxes 1 and 2, andeither box 3A or 38
I own, reside in, or will reside in the completed structure.
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3. A.f--_l My general contractor is
Contractor registration numbe
Date
Fi
1.
2
ll in the app
I will instruct my general contractor that ail.subcontractors who work on the struc-' ture must be rdgistereo *itn'i["'t,ilJ3r]ihion contractors Board.OR
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