HomeMy WebLinkAboutPermit Fence 1995-5-17
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SPRINGFIELD
FENCE PERKIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
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Job Location:
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Assessors Map #: 18-,::>;;> -r:::>S-.::2../
o'Wner:----\.(~ #e'!"/7,,~~~
Address: ~c;I ~'-'>/_;'- L.~ '
City:~. State:~_
or
Tax Lot #: ~~.:::z......
Phone
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Zip: q?.,.,.>~
Value of Fence: /$?~. ~
Fence Permit is $5.00
Contractor/Installer: ~~~~~~~~~-5> .
Address: P ;::?~.).- b~ Phone #: q'7~:;;:>--:>t:;?5
City: ,,~~-fJ;:]:!irC~ State:~' Zip: q~
Construction Contractors Registration #:~&1.22
Expires: /-v?~
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this application/permit is correct and that I 'Was provided 'With the Springfield
Development code requirements for fence standards.
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'Signature
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Date
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FOR OFFICE USE
Date of Application: .~,/'~~~~
Receipt # /74<'/'!)"
Total Amount Collected: ~ ~
Checked for Delinquencies: ~
Issued By:
JOB I: ~~/i.,;."Z5
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Checked for Historical Status:'.
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