HomeMy WebLinkAboutPermit Fence 1996-07-17225 North Fifth Street Springfield, Oregon 97477 rBNCE PBRHTT APPLTCATTON CITY OF SPRINGFIELD BUILDING SAFETY DIVISION SPrlTNGFrELI) Office: INSPECTION LINE: 726-37s9 726-3769 Job Location: L3& b. G+ S-f- Assessors Hap #: Ovner:lr.l <-i \ $ Lr ^A-S"\",,^a\(.r Address' 63F N b Lst Phone #: Ci ty:S \otL Zi p:State: Value of Fence:?Soeg Fence Permit is $5.00 /r.J.i\ *L\^f,* S -L.od\*"Con t rac tor/Ins taller : Address, t 3 f 6tla s f Phone #: Ci ty:State:o Zip: Constructlon Contractors Registration *: lly signing this permit/application, I agree to call- for an inspectlon once my fence has been constructed (726-3769). I also stated that aII informatlon on this application/permit is correct and that I vas provided vith the Springfield Development code requirements for fence standards. 7-t7-7 4 gnature Date POR OFFICE USE Expires: Date of Application: Receipt tt c Total Amount Collected:5 -\JoB *z nOOq 7)- rssued By,n - f)4clilAdc) Checked for Delinqttencie.s: 5D Cheeked for Ilistorieal Stattts: Tax Lot *:OOTC'D - LiJ- trfi ? 9)Yl7 fYf a) '7--la-qA Address: (eqK (p+ 3*ew Issueduy: 0 . Cnlc)-'ado Permit #: Date: 1- ll 4V Statemeht: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Constructton Contractors Board to sign the following statement before abuttding permit can be issued. This statement is required for residentiat building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. Thts statement will be filed with the permit. Fill in blanks and initial boxes L and2, and either box 3A or 38 1. I own, reside in, or will reside in the completed structure' 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or uPon comPletion. 3A. My general contractor is (Name)Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board' OR 3B. I will be my own general contractor' If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with G cig ano will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above informationis correct and thatl have read and dounderstand thelnformation on the reverse side of this form. (Signature of permit aPPlicant) (White copy to issuing agency perunit file, pink copy to aPPlicant) Notice to (Date) - /) ?67