HomeMy WebLinkAboutPermit Fence 1990-12-17
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAF~TY DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: 't;7'J A-sp en
Assessors Map #: 'I 7 O??~ zz...
Owner:' F=Lrf-(;\v..Q B ~~S
Address: zerc:; 3 IYl-e+o (! uS
City: Guc-I/e~ State:
t7
Value of Fence:12rD?5D. c.7D
Tax Lot #: 6<-\ 2-VZ)
Phone #: t.{t/7 3/7 b
O/Z- Zip: 77L(OI
Fence Permit is $5.00
Contractor/Installer: 61U~ V
Address: Phone #:
City:
Zip:
Expires: 6. (Y - 9 /
State:
Construction Contractors Registration #: ~f~J5(/J
3&c.j9'9
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 fence standards.
A:~h L:?~
Signature -j
/d:?-/7-9~
Date
FOR OFFICE USE
Date of Application: 1?_~J{-CjO
Receipt #: l~L(g Issued By:
Total Amount Collected: ~,CJ?)
Checked for Delinquenci es: ~
Job #: OJ ()'O <::J {/iJ
(~ () ----'
Checked for Historical Status: V-