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HomeMy WebLinkAboutPermit Fence 1995-06-16C'TY OF SPRINGFIELD, OREGO'U FENCB PERHIT APPLICATION CITY OP SPRINGFIELD BUILDING SAFBTY DIVISION :iPtltttGFrELo 0ffice: INSPECTION LINE: 225 North Fifth Street Springfield, 0regon 97477 726-3759 726-3769 Job Location: 11)) jiorth l+th 3treet Assessors Hap *2 17 )3 2; 3 b Tax Lot #: 03?OO Ovner: FraC l-cv E . ler Addressz 11J9 lriorth [th Srreet Ci ty: go' 3pringfield State: Cre2on zi p:1 ? d4o, u'Value of Fence:Fence Permit is $5.00 Contractor/Ins taller : €{fil'!:a'TraJ l<D a Address , l t O't AI .[T'^ Sf Phone *:1 z(e \ g&3 Ci ty:&(,,!State C€-Zipt ?tq T3?53 Construction Contractors Registration #:l.pA--Expires Nfr- By signing this permit/application, I agree to call for an inspection once my fence has been constructed (726-3769). I also stated that all informatlon on this application/permit is correct and that I vas provided vith the Springfield Development code requirements for fence standards. (A^,*ra, A-Ar^oSililture l I te FOR OFFICE USE Checked for Delinqueneies:t / Checked for Historical Status: o 3zDate of Application: Receipt # qTota} Amount Collected:d) Issued By: \ / 6tL ftxr e i?7{ Permit #: -tb -Issued by:n^*Date: Statemeht: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires resi.dential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I 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 (Narne) 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 38. 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 the CCB and will immediately notify the office issuing this huilding permit of the name of the contractor. Ihereby certify thatthe above informationis correctand thatl have read and dounderstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. I Ld ;-tw a/?1{ of permit (White copy to issuing agency pelrnit file, pink copy to applicant) tr N X (Date) c4"6018't-