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HomeMy WebLinkAboutPermit Fence 1993-05-10CITY OF SPF"UGFIELD, OREGOA' 225 North Fifth Street Springfield, Oregon 97477 FENCE PBRUIT APPLICATION CITY OF SPRINGFIBLD BUITDING SAFBTY DIVISION SiP,lINGFIELD 0ffice: INSPECTION LINE: 726-3759 726-37 69 Job Location: 3 n A) a<,/t-!.1)6 el - Assessors Map #:rax Lot *z O1@1 Owner: Address, QLfr N eSuJ Plu ", - phone *:1.t)-8S3" Ci ty:h"' r\AG k"-Or.l- state, OA zip: Q'> V -h J Value of Fence 2 6 oo"Fence Permit is $5.00 Contractor/Installer: Ot rn- nn ) Address:Phone #: Ci ty t State:Zipz Construction Contractors Registration *: Expires: By signing this permit/application, I agree to caII for an inspection once my fence has been constructed (726-3769). I also stated that aII information onthis applieation/permit is correct and that I vas provided vith the Springfield Development code requirements for fence standards. 3) I a ture Date FOR OFFICE USE Checked for Delinqueneies: lq> Checked for Historical Status ' ,./ Date of Application:elto Receipt # Eg 1a'-l Total Amount Collected, -X Issued By:DR JOB *:oQz ) 1 2 Permit No:Q5ouaz Address:?ar> A)ES@ PL lssued by OB Date:Are> R OFFICE USE ONLY STATEMENT: !NFORMATION 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 My general contractor is , Contractor registration 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 3.8 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. 3) rcl qt nature rm p cant Date CONSTR UCTION CONTRACTORS BOARD 0244J 8191 WHITE COPY TO ]SSUING AGENCY PERMIT FILE P]NK COPY TO APPLICANT 3