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HomeMy WebLinkAboutPermit Fence 1991-1-23 -. .- SPRINGFIELD FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street' Springfield, Oregon 97477 Office: INSPECTION LINE: 726-3759 726-3769 ~ .A Wfl' ~~ V Job Location:!ltNb Mr D!M{;fjj r-r Assessors Map #: Owner: I ,6r.h r:UMA1 P a (1/ILt!Jr5 Address: J I 7'1 ~/: 7e,- r Y' ,;[ r Tax Lot #: City: ,- ..t::::"Vc? .~I'/ P _ " State: a r? Phone 11: kJ5J?-6~9? Zip: ??~.&~ r Value of Fence: $/977,00 Fence Permit is $5.00 ContractorlInstaller: Eyer?',,- e eF7 ~/.'"c::-e Address: .3'?35----, )1/e8r //3!1:: Phone 11:?//.>5-c;&c:6- City: E/QR-p~e- State: ~/? / Construction Contractors Registration H: ::z. 7 '107 Zip: 977,c;:2- Expires: 7 ??5/~__ By signing this per~it/application, I agree to call for an inspection once my fence has been constructed (726-3769). I also state that all information on this application/permit is correct and that I was provided with the Springfield Development Code requirements for fence standards. , )2rAAAA~- ~&;~ Signature //..2;L/9! Uate FOR OFFICE USE Date of Application: Receipt 11:~ Total Amount Collected: 1-c93.Qj Checked for Delinquencies: Issued By: S,OO ( ~b H: q()/(JP'J0 C7l1 fJQ.) , Checked for Historical Status: '