HomeMy WebLinkAboutPermit Fence 1994-05-13225 North fifth StreetSpringfield, Oregon 97477
rBNCB PERMIT APPLTCATION
CITY OT SPRINGT'IBLD
BUILDTNG SATBTY DIVISTON
f;PN'NCF,ELO
7 26-37 59
7 26-37 69
Job Location:ri "{l* S+
Assessors Mup lt,7 b'Lo1 z Tax Lot lt:c.110 0
Phone tt: 7 4 Lt -?o./4
CtE-Zi p:€z 4zk
Fence Permit ts $5.00
0vner:
Address:
Ci ty:
Value of Fence:
Con trac tor/Ins ta]ler:
Address:
fl 5D
S ta te:
ntut^!r(
Phone *:
Ci ty r State:
Construction Contractors Reglstration lt:
By signin
fence has
this appl
Developme
ure
g this permit/application, I agree to call for an lnspection once my
been constructed (726-3769). I also stated that aII informatlon on
ication/permit is correct and that I vas provlded vlth the Sprlngfleld
rnt code requirements for fence standards.
zi p:
Expl res :
/
te
Date of APPIication:5 - i)-q -[JOB {t:4,_{
Receipt lt o
Total Amount Co1lected:
Lssued BY:
aD
C\rcclte<] [or Delinqttenc i es :L./ Check.ed tor llistorieal Stattts:
ca8
I
!
0fflce:
INSPECTTON LINB:
FOR OFFICB USB
Permit No:e '-)
Address:Thsr
lssued Date: |-JY
OR OFFICE USE ONLY
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 r.egistration numb
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
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 iegisiered with the Construition Contractors Board
and I will immediately notify the office issuing this building permit of the name ofthe contractor.
L
1
2
3
OR
I hereby certify that
the lnformation Not
reverse side of
the above information isrcorrect and that ! have read and understandrice to Property owners about construction Responsibilities on thelorm-
f-/3^7/ure Per Applicant
CONSTRUCTION CONTRACTORS BOARD
0244J Bl91
Date
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT