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HomeMy WebLinkAboutPermit Fence 1990-11-14 ',_ .'1... __ , ~'.."; -; . .sPRIFIELD FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: 4 ~ \\ 'N\~ S\j\Q\J t Assessors Map #: \ \ l'fd. ?J~ 7-{;l Tax Lot #: Owner: \i\~ r.o f\t:1 0 h\ Qf)t) Ll\) d AddresK ~D~ c~\J..") ~hT1\5 ~"Q~eld City: \(()(-t\0J\~ -St:te: CCl\ \) ~tr' .Zip: C{,A Q.S I')S r;J.J Fence Permit is $5.00 Co",,,,'oc""" 11&Lv1'1 f ~m\ hI) (\!.d ~ Address: \J, (). \2-;'Y.. K Phone #: "1 ~_\; 'CA4l City: ~~^t1.. State: (~. Zip: q14l7 Construction c~ractors Registration#: Lo \ 2JJr Expires: ~ f;li3ljq I fr~ D\O,tD ,or Value of Fence: 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. \! () ~,^^,,.------ o FOR OFFICE USE rrd( -I L/-'10 a e , ~nature Date of Application: ! ( .- 14~q 0 L-flOb-lJ: q 0 \ 01 ?; . Receipt #:J S-7~3~ Issued By: r:JJ I /jo. _) Total Amount Collected: ~. 60 Checked for Delinquencies: (_____ Checked for Historical Status: (