HomeMy WebLinkAboutPermit Fence 1993-11-24225 North Fitth Street
Springfield, Oregon 97477
FENCE PERHIT APPLICATION
CItY OF SPRI}IGFIELD
BUILDING SAFETY DIVISION
SPRINGFIELO
0ffice:
INSPECTION LINE:
726-3759
726-3769
TY OF SPB"VGF'ET.D, OREGO'V
Job Location: q'49 A) , E*N jl1)-t
0vner:
Address:
Ci ty:
Assessors Map #: 11O< 35 Dt Tax Lot *: C|,-,QOCl
ctzg N. g*t A+^rr-r Phone #: 1L+ I '1q 89
hn''u.,.*, {lra- state , OP zipt q1q1-
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6
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VaLue of Fence:o0
Con t rac tor/Ins taller :()trna r
Fence Permit is $5.00
Address:
Ci ty:
Phone *:
S tate:Zipz
Construction Contractors Registration #:E xpi res :
By signing this permit/applieation, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that alI information onthis application/permit is correct and that I vas provided vith the Springfield
Deve pment code requirements for fence standards.
I l^ 2v -Qa,
Date
FOR OFFICE USE
Date of Application: i I JoB *: Q3 t-QO
BReceipt #Issued By:
Total Amount Collected: 4'
^oo
Checked for Delinquencies: ,,/Checked for Historieal Status /
I
lr
Permit No:c
Address:3tat
lssued by: CB Date:lLz-ltj
STATEMENT:
R OFFICE USE ONLY
INFORMATION N OTICE TO PROPE RTY OWNERSABOUT CONST RUCTION RESPO NSIBILITIES
Fill in the applicable blanks, and initial boxes 1 and 2, and either box OA or 38
2
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 sordor offered for sate before ;arp; I#pretion.
Contractor registration number
Note: oregon L'y,-9Is 701.055(4) ,..requires residential-construction permitappticants who are. not register"i ilitn ih" c;;;i;,IJiion contractors Board tosign the rorowino strt"r"ii-o;;;,1:^t;16gilffiican
be issued. rhis state.ment is requiredi".ar".i;;,itTiiir=iiorn^g,_erecirila-i,'m""nanicar,
and prumbingpermits' LicensedArcnitect anotliginggr appricani., "r.rpt from registrationili:11flf:#H,,,fl?, ;;;; "oi J,B,it tniJ5i,i!'ij"ht rhis statemeii_wi, oe
'l
3.8
OR
I will instruct my general contractor that ail subcontractors who work on the struc-ture must be registered with tn" conrtruction contractors Board.
f& I will be my own general contractor.
lf I hire subcontractors, t wi, hire onry subcoTlrgtgrg registered with the construc-tion contractors Boardrl r ft,""s" liy"mind and do rrire-a generar contractor, r wi,contract with a contractor who is iegGLreo *iin n" C"nltiriction contractors Board,if J#'JJfi#ediaterv notify tnl otiice issuins rhis buirdins permit of the name of
I hereby certifv that-the above information is correct and.that r have read and understandff" [:' l']lT :1, lt, mJ: i;;fi ;'dil'; .;;1"b1 n s t ru cti o n R es po n s i b i r * i es on r h e
gnatu re of rm ca -q
Date
3ro.)rrltLY
oroN coNrRACro RS BoAR D
B', $,[ESSJ,IJ? lF#JIGac ENcy pER M rr Fr LE
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