HomeMy WebLinkAboutPermit Fence 1995-10-4 (2)
.
.
PENCE PERMIT APpLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
Job Location:
} 'II!) P A ('Y) h",u) /)'V' I~} tf7"
Assessors Map #: 17/}Z27?J Tax Lot #: t'J~/OO
- -
Owner: IIl1hrt4f-for !/VJrlOl?I-q, / <>;//rl~f-I.p(j /' E/./~...
Address: fl..{), toY' t/t2;>, Phone #: '/-1//-/'7/9; ..
,-
City: 5j,n;nj6-..-;d State: /)/ Zip: Q7t,/'77
i'# :>
Value of Fence: '0/'4.4) b
I
Fence Permit is $5.00
Address:
J/ob, I'd/- h>Y
10_ i'or 1/111>
Ci ty: ----51Z7";,~tf/~, fl>.Cd
, V
Construction Contractors Registration
#/~UMI7 '
Phone #:
7W-/7ttJ '7
Contractor/Installer:
State: 0.<'
#: JtJt1/J'i
nh/ /dd.5OT1
Zip: f"~'7/
Expires:
')...-1 r-Cft.
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
Development code requirements for fence standards.
(lo~../h1) J. ,~6'.A-"7~A_/
Signature (7 "r
f,J-4-<7S
Date
.
FOR OFFICE USE
Date of Application: /0-'9'-"'35"
Receipt # / 9/9 ~
Issued By:
JOB, I..:.... j95"" .#'?:' <V
/2.-~ -
~'_.
\.-
Total Amount Collected:
5:~
Checked for Delinquend es:
..---
Checked for Historical Status:
"
.
.
I I/(/L-{/l~/ C-#'/J7k 7}:> c
:(5~a"'#:?#~~r~ .
67f7 J7:' t4.:7P'E" ~
?#yU/? ffi?f~~/~
~7~/
~7-
i
I~
, ,