HomeMy WebLinkAboutPermit Fence 1992-02-25225 Fifth Street
Springfie'ld, Oregon 97 477
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRTNGFTELO
Offi ce :
INSPECTION LINE:
726-3759
7 26-3769
CITY OF OREGO'V
Job Locat'ion :
l\ssessors Map #:Tax Lot #: ll
0wner:
Address:Phone #:14t 1b 5z
City:State:
Value of Fence: rue -67)Fence Permit is $5.00
Contractor/I ns tal I er:
Address:Phone #:
Construction Contractors Registration #:Ex pires:
By signing.this permit/appligq!i9!r_l agree to ca1l for an inspection once my
fence has been constructed (726-3769). I also state that all information on-
this_applicat'ion/permit is correct and that I was provided with the Springfield
Deve'lopment Code requirements for fence standards.
*
si-
L Eh e( ?e
DateS i gnature I
FOR OFFICE USE
Date of App'lication, Z->6-i2-Job #:
Recei pt #: 6Zq Issued By
Tota'l Amount Col'lected ,
-1.
C)a
Checked for Del inouenci es: -/Checked for Historical Status i -*
?- zro, 4741K
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City: State: Zip: