HomeMy WebLinkAboutBuilding Miscellaneous 1994-7-27
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AL~ SYSTEM PERMIT
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CITY OF SPRINGFIELD
DEVELOPMENT SERVICES
225 FIFTH STREET
SPRINGFIELD OR 97477
DATE:3"-~ 7-Cj'~
IS THE ALARM SYSTEM BEING INSTALLED AT A RESIDENTIAL OR BUSINESS
LOCATION?
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RESIDENTIAL
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BUSINESS
If a residentially installed system, please complete questions
1 through 6. If the system is being installed at a business
location, please complete questions 7 through 13.
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1. Name: JJY'-"-=_"!~ k, 1 ~
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2. Address: \, l~, ~ u', U~\ +-
City:Spr..~ f-'\e..\d State:~ Zip: Q7'177
3. Phone Number: 71./1- 2. Y.i"LJ 4. Date of Birthycl><""- 2"2-2.(0
5. Is the system being installed by the homeowner? Yes No ~
If no, then indicate the company that will be installing the alarm
system:
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6. Date of installation:.."
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7. Business name (only if system was installed in business):
8. Owner Name:
9. Owner date of bi rth:
10. Business address:
City: State:
11. Phone Number:
Zip:
12. Company that installed alarm system:
13. Date of installation:
ELECTRICAL PERMIT REQUIRED