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HomeMy WebLinkAboutPermit Fence 1993-12-03SPFlTNGFTELE, CITY OF SPRINGFIELD, OREGO'U % FENCE PERHIT APPLICATION CIfY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 North fifth Street Springfield, Oregon 97477 0ffice: INSPECTION LINE: 726-3759 7 26-37 69 Job Location:lu-14 N, lqLSt' Assessors Map *:)D Tax Lot #: Owner: Address:/t-lJ Phone #:"t t+b- 43Ltb Ci ty:Statet 0A Zip:Ql q)) Value of Fence:4 )oooo Fence Permit is $5.00 Contrac tor/Ins taIler :,l)u/Yt/-rr Address:Phone *: Ci ty:State:Zipz Construction Contractors Registration *:Expi res : _ By signing this permit/application, I agree to caII for an inspection once my fence has been constructed (726-3769), I also stated that all information on this application/permit is correct and that I was provided with the Springfield Developm code requirements for fence standards. tl14qz s a e Date FOR OFFICE USE Date of Application:t)nn *z Q3 )R /) Receipt # llCbl Issued By:C Total Amount Co}lected, 4 oc) Checked for Delinquencies: L/Checked for Historical Status z ,-z' 141r-' Permit No Address: Q3t t2 lssued by fre Date l) t*',, 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 underORS 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 1 2 Gq4 /v lqw>t- WHITE @PY TO ISSUING AGENCY PERMIT F]LE PINK COPY TO APPLICANT 3 My general contractor is , Contractor reqistration number-. 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.l - -l 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 information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. i4dqz rmit App cant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8t91