HomeMy WebLinkAboutPermit Fence 1990-08-24FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
State:
SPFTNGFIELD
Offi ce:
INSPECTION LINE:
225 Fifth Street
Springfie'ld, 0regon 97 477
Job Location:
As ses s ors
0wner:
Address:
City:
fl'\
726-37s9
7 26-37 69
I Tax Lot #:
Phone #:
Fence Permit is $5.00
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O, ODVal ue of Fenc
Contractor/ I ns ta I I er :
Address:
City:State:
Construction Contractors Registration #:
gn e
FOR OFFICE USE
Li p:
.-- Ex pires:
By signing. this permit/app'liqq!i9!, I agree to call for an inspection once myfence has been constructed (726'3769). I also state that all information on-this application/permit is correct and that I was provided w'ith the Springfield
Development Code requirements for fence standards.
3 -e4-70ffi
CITY OF SPR"VGFIELD, OBEGO'V
Date of Application:Job #:
Receipt #: 62'A Issued By:(un n^ o
tr<.
r- 'lTotal Amount Collected:
checked for Del'inquenci "5, ,----- checked for Historical status:
'-
Phone #:
#:
9cr rro
Permit No:
Address:
lssued Date
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. 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 box 1 and either box 2A or 28:
I own, reside in, or will reside in the completed structure.
2.4 My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
1
B.I vyill be my.owl general contractor
i ., /, .'i' t,/
It I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. lf I chanqe my mind and 6o hire a oeneral
contractor. lwill contract with a contrattor-who is reoistered w-ith the
Constructibn Contractors Board and I will immediately-notify the office
issuing this building permit of the name of the contradtor.
I hereby certify that the above inlormation is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
Date
r)
t 7o
CONSTRUCTION CONTRACTORS BOARD
o244J 10t24t89
COPY TO ISSUING AGENCY PERMIT FILE
PY TO APPLICANT
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