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Home My WebLink AboutPermit Fence 1994-1-7 .' .- SPRINGFIELD FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 North FIfth Street SprIngfIeld, Oregon 97477 OffIce' 726-3759 INSPECTION LINE' 726-3769 A ~() ( 00 iW~f\ f\ l{lSlJ Assessors Map #. \f).().::)~ ~ "\1 . ~ - Tax Lot #. o\tom owner'~~M\ ~tJJ~m~~) Address' rIJ')() ( (10 f1flJ"flJ11l) (J Phone #. CIty ~0p-u N State fJJPO(M ZIp" Value of F~nc~n-n ~ Fence permi~ is $5.00 Job LocatIon: ~') ~()(nt() LlYMVl f) I Contractor/Installer //0/'/)"1 A ~ ). AV(: /V{)t'(2-- Address' "l 7 0 I ('I-' /11 It!" rr/ /J (A '- CIty' '7;71J.. I .rVcyr:;:-, (:'1-0 State ()12 I ConstructIon Contractors RegIstratIon # Phone #. 74 7 - 0 b '-I 0 ZIp" 171 7 "7 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 code requirements for fence standards. ~f>~_~~Ju 'S'lgna t u re -----. (-'1-9''-1 Date FOR OFFICE USE Date of ApplIcatIon' i--0 -q4 ~ ~ #: C{4lY)~~ Receipt # \ \ ~ Issued By(~./'\ 4./'\ 0--. Total Amount colle:t~d: 6:J.W '--f - ----.., Checked for Dellnqupnr;ps' Checked for HistorIcAl StAtUq' Permit No C\ ~/~)~ 1) Addrn" !}.Y)D J (1 m J Q//rUg 17 Issued bC!)Im ~, Date 1-. . 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 from registration under ORS 701 010(7), need not submit this statement This statement will be filed WI h the permit Fill In the pplicable blanks, and Initial boxes 1 and 2, and either box 3A or 3B 1 1'>< I I own, reside In, or will reside In the completed structure c. -.. 2 I \/^; I /v 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 I~ Contractor reglstrallon 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 I 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 mformatlon 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. $VV1f~~~ /~ Signature of Permit Applicant . Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COpy TO APPLICANT ,"" INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE This Information Notice to Property Owners About Construction Aesponslbllllles was developed by the Construction Contractors Board In accordance with OAS 701 055(5), 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 EMPLOYER RESPONSIBILITIES If you hire persons not registered with the Construction Contractors Board to do labor In constructing or assisting In the construction or Improvement of a residential structure, you Will, In most Instances, be ruled to be an "employer" and the people,You hire Will be "employees" As the employer, you must comply wIth the follOWing Oregon's Withholding 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 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 information, call the Oregon Employment DIVIsion DHR at 378-3224 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 fall to obtain workers' compensation Insurance, you may be subject to penalties and Will be liable for all claim costs If one of your employees IS Injured on the Job For more tnformatlon, call the Workers' Compensation DIVISion DIF at 373-7434 US 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 221-3960 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 b"l brought to your atte[ltlon through Inspecllons Liability and Property Damage Insurance Contact your Insurance agent to see If you have adequate Insurance coverage for accidents and omiSSions such as failing 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 time to supervIse your employees Experlise 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 InspectloRs 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