HomeMy WebLinkAboutPermit Fence 1991-7-12
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SPRINGFIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: ~bO ;5t!.offs
Assessors Map #: \103 Ql \0
Owner: ;:;/'=-k.L.<".... J??~ ~
Address: qM e5f1. o~ ~.)) ,
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Tax Lot #:
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Phone #: '11/'7- $//, 0 '
City: C)r(t
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Value of Fence: 7,;<3./
State: ~~ Zip: t17YY1
Fence Permit is $5.00
Contractor II ns ta 11 er: /1,
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Address: ? 0 ~ 3.(,
City :4,oJ"'/1 c/~" /,j Stat~:.1'5A..o..
Construction Contractors Registration #: ~/J't b
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Phone #:'7~it - t?S:z. ~
Zip: 971//'1
Expires: J.:2. -j' 1- 'fJ
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
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Si'gnature'
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, FOR OFF ICE USE
Date of Application: '\, \'2..C\ \
, Receipt #: r'1Jlo9:1 Issued
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~ Job /I-: q. \()R~{l
By: (f()),
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Total Amount Collected:
Checked for Delinquencies:
Checked for Historical Status: