HomeMy WebLinkAboutPermit Fence 1991-01-24225 Fifth Street
Springfield, Oregon 91 477
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
siPRIl{GFIELED
Off i ce:
INSPECTION LINE:
726-3759
726-3769
CITY OF OREGO'V
Job Location:2or I (8t 5+.
Assessors Map +: /7na 3A eO tax Lot #:5*a
Owner :s A
Address: Zot sj I ltt, Phone #z aZb' 3'zce 3
Soe.,ru,r f rg I b State z b Z.Zi p:9trt-77City:
Value of Fence:Qleo:Fence Permit is f5':t0-c/ry N/*
o/*^rr.)
Construction Contractors Registrat ion *: 1// &, 1. txpires ' /4 +
By s'ign'ing this permit/appl igl!i9l r-l agree-to cal I for an 'inspection once my
fence has been.6nt[rr.[-.[ ti2o-gt6s7.
-I also state that al] information on
tnii-appiicationipermit is iorrect anO that I was provided with the Springfield
Devel opinent Code requ'irements f or f ence standards .
t* >+-
Contractor/I nstal I er :O^)
Address:Phone #:
City:State:Zi pt ) 2y'77
YhW ?
gna ure
FOR OFFICE USE
Date of Application:Job #:
Rece'ipt #:Issued BY:
Total Amount Collected:
Checked for Del'inquencies:--Checked for Historical Status:
ner
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