HomeMy WebLinkAboutPermit Fence 1990-08-01SPIIINGFIELO
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FENCE PERMiT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Flfth Street
Spri ngf ie'ld , 0regon 97 477
Offi ce:
INSPECTION LINE:
726-3759
7 26-37 69
YNJob Location:
Assessors Map
owner, \{ o
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#:Tax Lot #:08000
Address:Phone il:
Fence Permit is $5.00
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City:State:
$Val ue of F ence:
Con tractor / I ns ta I I er :
Address z fr
City:
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State:
Construction Contractors Reg'istration ll:
ure
FOR OFFICE USE
By signing this permit/application, I ag
fence has been constructed (726-3769).this appl icat'ion/permit is correct and t
Development Code requirements for fence
ree to call for an inspection once myI also state that all information onhat I was provided with the Springfield
standards .
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Phone /l:
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(* Ex p'ires:
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Dabe of Appl ication:Job #:q
Receipt i/:Issued By:
Total Amount Collected:
checked for De'linquencies: / checked for Historical status:
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Permit No:
Address:
lssued by Date:
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERSABOUT CONSTRUCTION RESPONSIBILITTES
Fill in the appricabre branks, and initiar box 1 and either box 2A or 2,,:
r' rt r own, reside in, or wirr reside in the compreted structure.
A.My general contractor is
Contractor registration number
I wi' instruct mv generar contractor that _ail subcontractors who work onthe structure must-be r.giJt"i"i*iii, tn; e".;i;*t;;; contractors Board.
Note: oregon Law, oRS.7o1.055(4), requires residential building permit applicantswho are not reoistered with tlie'Construction Contractors Board to'sign thefollowing staterient before tne-ouiloing permit can be iisued. Licensed Architectand Engineer appricants, exempt from iegistration Lnoer oRS 201.010(7), neednot submit this statement. Thi; statemeit *irr o" riieo ,ritn the permit.
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OR
I will be my own general contractor.
tr#fli.,*;i tl*arUii[[,iti#h?iHr*mi il:;drssuing this buitding deimiT;T't"h;'
I hereby certifv that.the 3bove information is correct and.that_t have read and understandl3;, I f 11]T,ll, lii mJ: ;;il fii'o
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