HomeMy WebLinkAboutPermit Fence 1996-8-1 (2)
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FENCE PERHIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 ~orth Fifth' Street
Springfield, Oregon 97477
Office: ,726~3759
INSPECTION LINE: 726-3769
Job Location: <7'<?~ c; #.e~77*/ct
Assessors ,Hap #:1 <s tJ 2. 0 L.to OO;Jq OVTax Lot #: , ~
Owner: ~ ~ 1~5
Address: /'1) "7() ',tC'/-"o..<:. c.r
City: LL!.4>t</1:.u. State:
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Phone #: /'-/'f~t72&")
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Zip: '9'/,/26
Value 'of Fence: J.s1Jd,c:o
Fence Permit is ,$5.00
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Contractor/Installer:
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Address:
Phone #:
City:
, State:
Zip:
Cons.truction Contractors Regist~ation #: ,
Expires:
By signing this permi t/'applicatiOli, I agree to call for ail inspection' once my
fence h;]s been constructed (726-3769) . I ;]lso stated that all 'information on
this'application/permit is correct and"that I was provided with .the Springfield
Development code requirements for fence ?tandards.
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J>),/9f:,
Date,
"':'"
Signature
FOR OFFICE USE
, Date of Application: '
f5 -(-9 (_
Receipt n
127l 4
I
Collected:
Issued By:'
JOB II: 9~CJ 9"32.-
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Total Amount
c;-: on
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Ch~cked' for Historical Status:
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,Checked fOL- Delinquencies: