HomeMy WebLinkAboutPermit Fence 1993-8-12
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDI~G SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
City:
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Tax Lot #:
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Job Location:
Assessors Map #:
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Owner:
State:
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Phone #: 7L{ 7,' / to 5()
Zip: q7L/77
Address:
Value of Fence: X"02:) . 00
Fence Permit is $5.00
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'Contractor/Installer: ()~v
. Address:
Phone it:
City:
State:
Zip:
Construction Contractors Registration it:
Expires:
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 COd,". req~r~ents for fence standards.
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FOR OFFICE USE
Date of Application:
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Receipt #
Otc:; ~ I
Issued By:
JOB #: q ~ l:lo ()
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Total Amount Collected: $ S cO
Checked for Delinquencies:
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Checked for Historical Status:
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Permit No:
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nJvVV~_ Date: ~ .-}2~,
Address:
Issued by:
FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt trom registration
under ORS 701.010(7), need not submit this statement. This statement will be
fi led with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
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1. I f _ I 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.
3. A.I
I My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. B. I \f I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I 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 understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
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at re of Permit Ap'plicant ()
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Date
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CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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INFOR!.'ON NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTI'ONRESPONSIBILlTIES
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NOTE: _ This l!lforlT!ation Notice to Property Owners About Construction Respon~ibiliti~s
was developed by the Construction Contractors Board in accordance wittl ORS 70f055(5)'j ,
_ passed by the,; 1989 Oregon ,Legislature. .'
If you are acting as your own contractor to construct a new home or make a substantial improvement to an
existing structure, you can prevent many problems by being aware of the following responsibilities, and areas
of concern. '.. :-
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EMPLOYER RESPONSIBILITIES: .
If you hire persons not regis~ered with the Construction Contractors Board to do labor in constructing or assisting
in the constrl,lction or improve,ment of a resid~ntial structure, you will, in rl]ost instances, beJuled to be an
"employer" al]d!he people YOl! hire will be "employe~s". As \he employe~, you must comply with the following:
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Oregon's Withholoing..Tax Law: As a'1 enipl.oy,er, you must withhold income taxes from employee wages at
the time employees are paid. You will, be liable for th~ taxpaymemtseven, if yo~ dO,p't a~tuSllly withhold the
tax from your employees. For more information, call the Oregon Department of Revenue..at 378-3390.
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 Jnformation, call the O~egon Employment Division DHR
at 378-3224. '
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worke~s' Compensati6~ I~sur~nce: As an e~PIOyer, y~~ '~re:subject to(fhe Oregon Workers' Compensation
Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers'
compensation insurance, you may be subject to penalties and Win be liable for all claim costs if one of your
employees is injured on the job. For more information, call the Workers' Compensati~n Division DIF at 373-7434.
U.S. Internal Reyenue Service: As ,an employ~r, you must withhold federal income tax from employees' wages.
You will be liable for the tax paym~nt even iLYQLJ ,didn'~ actually'withhold the tCiX. For more information, call
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the Internal Revenue Service at '221-3960. ,,' '-'" ,
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OTHlIER RESPONSIBILITIES AND AREAS OF CONCERI\!: ,
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.
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Liability and Property Damage'lnsurance: Contacfyourinsurance agent to see if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint overspray,.water damage from pipe punc-
tures, fire, or work that must be re-done,
Time to Supervise Employees: Make sure you. have sufficient ti'Tle to supervise ,your employees.
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Expertise~, Make sure you have the expertise to act as your own general contractor, to coordinate the work
of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform
the required-inspections. ' .
If you have additional questions, write to:
Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310~0151
Phone 503~378-4621
":'0244J 10/24/89"
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