HomeMy WebLinkAboutPermit Fence 1996-1-25 (2)
....
.
.
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUIWING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
Job Location: 3\0 \ \ tnl nQn D ')
Assessors Map II: \ OWn\?!\
Owner: \ ~ l 01\
Address:. m .....AD ~rn....
City: ~Di: -
Value of Fence: ~,--
Contractor/Installer: OOOL)
Tax Lot II:
('2JdY1
State:
Phone
19\L
1I~1.lMlY<o
Zip: cn4-R? '
Fence Permit is $5.00
Address:
Phone II:
City:
State:
Zip:
Construction Contractors Registration II:
Expires:
~
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
",~~:~~::.f" f"" .,.,d.,d.,
rJignatury -,.~ Date
FOR OFFICE USE
Date of
Application: I ras (f(r']
~C) \1~-
Issued By:
q5< J IfF,
Receipt II
.-
Total Amount Collected:
Checked for Delinquencies:
Checked for Historical Status: