HomeMy WebLinkAboutPermit Fence 1994-8-2
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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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Assessors Map #: 17 0 2-. 31 L/ if
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Address: L-f0Lt~ ti~eCCto-- sr
Sf ~d State: ~
Value of Fence: J\~ 70W
Job Location:
Tax Lot #: Do 7/ J
Owner:
Phone
#: 7i-7-()cP(c
Zip: q 747 Y
Ci ty:
Fence Permit is $5.00
Contractor/Installer: l)lJJ ~
Address: Phone #:
City:
State:
Zip:
Construction Contractors Registration #:
Expires:
TIy 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
Develorment code requirements for fence standards.,
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Signa ture '
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Date '
FOR OFFICE USE
Date of Application: R ---7..__--f"J
Receipt # i 4 (Lr
Issued By:
JOB #: ' q L{ U 77
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Total Amount Collected:
0.6D
Checked for Delinquencies:
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Checked for Historical Status: I ________-
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Permit #:
'4 LfU77
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Address:
Issued by:
Date:
Statement: Information Notice to Property Owners'
About Construction Responsibilities
Note: Oregon Law, ORS 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 c~n 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 be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
1. I own, reside in, or will reside in the completed structure.
- 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
. before or upon completion.
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OR
bdj 3B. I will be my own general contractor.
If! hire subcontractors; I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind 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 that I have read and do understand the Information
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Notice to Property Owners about Construction RespQnsibilities on the reverse side of this form.
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(Signature of permit applicant)
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(Date)
(White copy to issuing agency permit file,
pink copy to applicant)
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- Information nNotice'; to Property Owners
About Construction ~esponsibmties
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, \ Note:' This.lnformation Notice to Property o-~y.ner~9bQut Construction Responsibilitles\,:' ',.',
'wa:5 delleloped by Hie Consiru-dimi Contractors Boardzn 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 preyent many. problems ~y being aware of the follow~ng responsibilities and areas of concern..
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EMPLOYER RESP'ONSIBILlTIES: "
If you hire persons not registereq with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improverri~nt of a residential structure, you wi1l,~in most instances, be ruled to be an ~mployer and the people
you hire will be employees, As thef?mployer, you 'must comply with the f?llo~ing; ,
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Oregon's withholi!ing tax law: As an employer, you must withhold income taxes from employee wages' at the time employees
are paid. You will be liable for the tax payments even if you don't actually withhold the tax fr~m your employees. For more
information, call the Oregon Dept. of ReVenue at 945-8091. .
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 OregQn Employment Di vision at the Department of Human Resources
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 ~our employees. If you fail to obtain workers' compensation insurance, you may
be subje-ct to penalties arid will be liable for all claim costs if one of your employees is injured ot! the job. For mQre information,
call the Workers' Compensation Division at the Department of Consumer and Business Servites 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 1-800~829-1 040. ,-
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 property damage'insurance: Contact your, insurance agent to see if you have adequate insurance coverage for
accidents and omissions such _as falling tools, paint overspray, water damage froI:Il pipe punctures, fi~e, or work that must be
re-done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Mak~ -,sure"y~uhave the exphttise to act as your (rwn general contractor, t~-coordinate the work of rough-in and fi~ish
trades, and to notify building officials at the appropriate times 'so-they 'can perform the required inspections.
If.you haye additional-questions, write or call the Construction ContraCtors Board (PO Box 14140, Salem, OR97309-5052,
503/378-4621). The Board is located at 700 Summer St. NE Suite 300,iJ:.1 Salem:: --'
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