HomeMy WebLinkAboutPermit Fence 1991-7-9 (2)
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S'PR!-FIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Skeet
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location:. C)~~CC0 \:X\i~\ ~( 11 f\\ 0
Assessors Map #: \ 7 O!1 g ~ oD lJ Tax Lot #: ) ~ on , .
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Owner: Ed,A1_A/'.d .f...!.../ f):'f4-~r I 7//4./11" r . _ e~M.I ~ l:<,,/.) "t-,d?7> ~?~"'t!'"r
Address:~~3~Li) J)~>~.V ~/ - .~.o. #7.L: Phone #: '/t./ 1- 5'96 <7
City: ..<0 Pd. State: f)J? Zip: 9?Cf??
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Value of Fence: ~SDO..Q
Fence Permit is $5.00
Contractor II ns ta 11 er: OI,L: (' ...--5 e ( ('J e <
Address: Phone #:
City:
State:
Zip:
. Construction Contractors Registration #:
Expires:
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
~his application/permit is correct and that I was provided with the Springfield
Development Code requirements for fence standards.
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, FOR OFFICE USE
Date of App'i'ication: 'I. /() .ql , j"iJob D: C\ \()~ ~
Receipt #:.-Bn(03~ Issued BY:(/)tfX) ')"
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Total Amount Collected:
Checked for Delinquencies:
'Chevked for Historical Status:
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