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HomeMy WebLinkAboutPermit Fence 1989-12-6 ....-' '. FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: ;.JLj. flq '--rnt1A~ .s+ Assessors Map #: /1 D;l :'3 -::2 J,:}.. Owner:' i9-rc:tI'l+S lc1ndsca..f,nj Address: PO 60i 'J:1-) . City: ,c.,().{:-~ State: I $ '00 Value of Fence: cQ(043. Tax Lot#: of) ~ Phone #: '7Jjp'Y03c.t o f2..- Zip: ql L/:- 77 -,. Fence Permit is $5.00 Contractor /Ins ta 11 er: d'Ji'€?-t1O YI ./ Address: (;~S-q fJ .3.r-l1t City: L:..O[:iA. - I Construction Contractors Registration #: c() fP M.CR_ sf- Phone #: 14& - f'3 J-cf Zip: Ony.7R Expires: IJ.j,~ 11L7 / I {jrL tjJl ~ b State: By signing this permit/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. e ,.f7 -kJ-,~ Signature /2. -,e - t'j1 Uate , FOR OFFICE USE Date of Application: l;)j(p IRc] Job #: r?q.J OL~ Receipt #: f.'?<f.CJ/ ", Issued By: ( k-~ Total Amount Collected: 5.(}() () - Checked for Delinquencies: ~ t/ Checked for Historical Status: