HomeMy WebLinkAboutPermit Fence 1994-03-18CITY OF OREGO'U
FENCB PERHTT APPLICATION
CITY OF SPRINGPTELD
BUILDING SAFETY DIVISTON
SPRINGFIELD
0ffice:
INSPECTTON LINE:
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225 North Fifth Streer,Springfield, Oregon 97477 726-3759
726-3769
Job Location:f{ ry^ I
Assessors Map *t L Tax Lot *: C ZZ m
0vner:iV\e-i. t *r AUr&n t CS lltlr.rq-ti,
Addressr lilO b NI F* ,*
Ci ty:State Af,-
Issued By:
Phone #:1q t- Prz
Zipz ltqtt
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Value of Fence:o4-oo Fence Permit is 95.00
Con t rac tor/fns taIler :
Address:Phone #:
Ci ty:State:zip:
_Expi res :
Sign ure Da e
FOR OFFICE USE
By signing this permit,/apprication, r agree to carl for an inspection once myfence has been constructed (726-3769). "r arso stated that alr information onthis application/permit is correct and that r vas provided with the springfieldDevelopment code requirements for fence standards.
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Date of Applicatiorr: 1 -t8 -q4
Receipt #
TotaI Amount CoIIected, &
Checked for Delinquencie.s: .*z-
JOB *:q 4 czq?
Checked for Historical Starus. i/'
Construction Contractors Registration #:
Permit No:4,r+ol,4.g
Address:
lssued oy, [L,i,lt^o- Date: lJI 1/
1
2
R OFFICE USE ON
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.B 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 ! have read and understand
the lnlormation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
ure o rm pp cant
CONSTRUCTION CONTRACTORS BOARD
o244J 8191
3
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
OR