HomeMy WebLinkAboutPermit Fence 1994-8-1
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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 Location: ~&'S- d~/Y"j}~4 174 / ~P/"5h'eb
Assessors Map #: !--D135~0-=-O.fdDD 1 Tax Lot #:
Owner: ~ "G.4-?'J --S: /16 / jr ~
Address: -;7 0 r:; c;- /!?/t/-t! J:;el/~ Phone #: 720- ?V?~
City: ~y(rV1.<. State: Zip: 774/-7rP
Value of Fence: ~ c:/ 0 Fence Permi t 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
fence has been constructed (726-3769). I also stated that
. this application/permit is correct and that I was provided
Development code requirements for fence standards.~
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Slgna~ ~ Date
FOR OFFICE USE
inspectiori once my
all information on
with the Springfield
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Date of APPlication:~- \- C\ ~\
Receipt # \~\\~0
To tal Amoun t Collected: a (..-:.-
JOB #:
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Issued By:
Checked for Delinquencies: ~I {
Checked for Historical Statlls:.1..}l~',
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Permit #: C\ h.\ \ \(0 L\
Address:
ISsued bY~~
Date: 8- \ ~ C\ '--\.
Statement: Information Notice to Property:Owners
About Construction Responsibilities
Note: Oregon Law, DRS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will befiled with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
,/ ~. I,own, reside in, or will reside in the completed structure.
~ I understand that I must register as a cOllstruction contractor if the structure is sold or offered for sale
. before or upon completion. , .
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OR
l.f}-3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mirid and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the '
name of the ,contractor.
/" I hereby certify that the above information is correct and tliat I have read a~d do understand the Information
Notice~ tProperty 0 ers about constructio. n Responsibilities on the reverse side of this form.
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/ (Signatureofpermitap~ (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
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"Information N'bticeto Property Owners
About Construction Responsibilities
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;-'//-" - /Note:-lbis Information Notice to prop'erty. Ownqs about Construction Responsibilities\ _.
1-- , 'wdsdeve!oped by the Con..~.trucJi(in-toiiiractors Boardtn accordance with ORS 701.055(5).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can preve,nt many problems by being aware of the following responsibilities and areas ofconcem.
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EMPLOYER RESPONSIBILITIES:
If you hire persons 110t r~gisterep with the Construction C<;mtractors B. ,oard -to do labor in constructing or assisting in the
construction or improvement.9t a residentia~ s~!1-lcture, you will, in ~osqnstar:tces, be ruled to bean,employer and the people
you hire will be employees. As the employer, you must comply with the following:
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Oregon's withhoiding.tax law: As an employer, you must withhold income taxes from employee wages atlhe time employees
are paid. You will be liable fot the tax payments even if you don't" aCtually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at945~809 L ". . -
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resourc.es
at 378-3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. If you fail to obtain workers' comp.ensation insurance, you may
be subject to penalties and will be liable for all claim costs if one of your employees is i~jured of! thej?b. For more information,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
u.s. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections. .
Liability and prop~rty 4amage insurance: Contact your insuranceagynt to _se~ if you have adequate insurance coverage for
accidents and omissi.ons such as falling tools, p~iI}t oversprjlY, \Vat~r damag~ from pipe punctures, fire, or work that must be
re-done. . _. -.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own gene'rai contractor/to coordinate the work of rough-in and fiftish
trades, and w notify building officials at the appropriate tim~s so'they can "perfoim the required 'inspections.
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Ifyouhdve additional:questions, write or call the Construction Contractors Board (PO Box 1~140, Salem, OR 97309-5052,
503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem., ,
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