HomeMy WebLinkAboutPermit Fence 1994-4-18
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
Job Locatio~: ,--(X)loR~{Jr'l)lJ ~~r1+) vPrY'i~ ,
Assessors~p #: 1f)0~Q'S43 Tax Lot #: CO~
o~ne~09( f\ll~
Address: oloA~ l' ~ y~O Q;tj{ -/ Phone #: 006-mlf)
City: ~) ~ - Stat~: (UJ!) ziP:91413
Value of Fence:U I ,()()D.OO
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Permit is $5.00
Contractor/Installer:
Address:
Phone #:
City:
State:
_Zip:
Construction Contractors Registration #:
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
'::C'"' 'Od~"" foe f,"" ""d"d,. q ~ /8 -'t yo
Sf)snature-- .- P Date
FOR OFFICE USE
Date of APplication.' 1-' \5,Q4
Receipt # f~ (::S~- Issued
Total Amount Collected: ~~) ~
JOB #:~).~8Q
By:(j l ( j) ,Q )
Checked for Delinquendes:,
Checked for Historic~l St~tUR: