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HomeMy WebLinkAboutPermit Fence 1991-7-12 -. ......- SPRI:tr'FIELD FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: ,-o,tA ~ ,lJrrl1 ~ G.\ Q\\ AssessOjs rap #: 1?-C>3-:<?-/5,l\... _ Tax Lot #: (tP2.&>e;> owner:C-'=1.('{I/OJ J.P /1, ~ J1l// h72.rS Address':_f1qq f) l~x11J/ Phone #: I r/l5/~-Cf(a '-~ City: ~(rJJ f\Q (late: (OL - Zip: q nJQI/ - 0 I~ Value of Fence: lQm~ Fence Permit is $5.00 Contractor/Installer: G~QC\ ~~\\.J\ ~ Address:~04-1-\)CU~'h\\~ J\tyhone #: 4\0 \-~\?iS City:, U ~Q nQ State: ~ Zip: Q1jOJ_ Construction Con\+actors Registration #: b 7q,.97 Expires: '7/~h) 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 fenie :tan~ards. il GJ::I" - I -~K~ rL-f/~ _*h~'trtd gJ " ,~ Sign'a'ture /7' \. V ' I/J- // - q/J Date FOR OFFICE USE Date of Application: /o-~9i:? Receipt #:. /B''/2<7 Issued By: Total Amount Collected: ~.~ Job #: 9()/;;vC/ ~~~~ P/'t/ ,/ Checked for Delinquencies: Checked for Historical Status: