HomeMy WebLinkAboutPermit Fence 1996-5-29
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sr-nINGFIELD -
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
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Job Loca t ion: <72'? ,I /1
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Assessors Hap #: J / 0 3> d ) "?:, I
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Tax Lot #: 0010 ~
Owner:
J(}t')l.o\
Address: 9~"< LJ.
City: <yr,-'""t',..r)
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Value of 'Fence~~ sm. CJJ
Phone #:
717 -/'1'10
97177
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State:
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Zip:
Fence Permit is $5.00
Contractor/Installer: s-k.-ue- '~.::\-H-r~ -.J.,.J~:-+r
Address: R2:; W. (J(A )yvJ-f- Phone #: 7"'17- /4'70
City: '<;A/? State: 01''/ Zip: q7477
Construction Contractors Registration #:
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Expires:
By signing this permit/application, I agree to call for an inspection once my
(ence 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
Development code requirements for fence standards.
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Signature
<,ik"E
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5-/29 I" l.-
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Date
FOR OFFICE USE
Date of Application: S"- ;}CJ'- Cj' (/J
Receipt # ~Jf-J-1 '-f ( 1/loq0\
Total Amount COllected:]t =>. l)l)
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JOB 1l:.q~o7L.5
Issued By: (). (h~ (In '0 d 0
Cllecked (or Delinqupnries:
Checked for lIistorical Status:
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