HomeMy WebLinkAboutPermit Fence 1991-7-12
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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/
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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.
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Sign'a'ture /7'
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Date
FOR OFFICE USE
Date of Application: /o-~9i:?
Receipt #:. /B''/2<7 Issued By:
Total Amount Collected:
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Job #: 9()/;;vC/
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Checked for Delinquencies:
Checked for Historical Status: