HomeMy WebLinkAboutPermit Fence 1992-2-11 (2)
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FENCE PERMiT APPLICATION
',CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street'
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769'
Job Location: : z to G" l':)u(I'S~
Assessors Map II: t 7 D "Z.. '36 '3<-1
Owner: ]AtJYeJ I "E:llI\lvtj,.e-r
Address: 12- ((J c, -0;/)..../ Sj 5-r
City: CpfrJ , ,State:
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Tax Lot II: Oz.z.oc:;
Phone II: 7cf7 '-f550
, ()fZ- Zip: Q7t.f.7fj
Value of Fence:_' ~l/" gs
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Fence Permi ti s $5.,00
Contractor/Installer: ~ C:Yl VI
Address: PO 'bop-1l7
P UMttvcJ- (;A'{ ( State:
Construction Contractors Registration II:
1--eM c e. c/,- '/'::oj:'1 L
Phone II: {, Lj '-/ 03 zX
Zip: .!i.:1...Lf5 0
Expires: ~.1.112-.(J !q?
(J72_
7 & 2Lf5?
City:
, 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.
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Signature /
z.. /;1//19.:>,
UatEY' / ' ,
" FOR OFFICE USE,
Date of Application: :7_ -f I-q~',
372-17
Total Amount Collected: ~,(1)
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Receipt II:
Issued By:'
Job II:,' or,ZOl '-{a
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Checked for Delinquencies:
Checked for ,Historical Status:
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