HomeMy WebLinkAboutPermit Fence 1995-12-11
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
,
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: ;;.,. -5~ ~//~~L~ .~ .
Assessors Map #: 1"/ 'O~-<?-/'2
Owner: ~q-~.# l? /~?
Address: "3'1~?7?~L~ Y/t:F~
City: ~ZJrl-f State: ~.
Tax Lot #: C>/-:::J.t:>h
Phone #: 7L./~~$'YC/c;
Zip: 9.::::>'7>'::>
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Value of Fence:~~~ ~
Fence Permit is $5.00
Contractor/Installer: #.JM'~S 0~...../ /""#~/~ _
Address: 7"/~ rlb:j~Ai:- /fl. Phone #:_~/'Q"'".a:::;-
City: b~c-~ State: /;;;7)'r Zip: q;;>S/~9'
Construction Contractors Registration #: '7;,;;;;;-Y"'=i' Expires: 7-'.....2$' '$"
By signing this permi t/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
Deve~. ~od:.~eq)uirements for fence standards.
'-1( ~~J l~ 111/<( S-
Signature Date
FOR OFFICE USE
Date of Application: /2-/r9.~
Receipt 1I /",}7f2: '?
Total Amount Collected: :;;: ~
Checked for Delinquencies: j(
JOB II: ~/g:::--./
tssued By: 7~ -
Checked for Historical Status: ~
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