HomeMy WebLinkAboutPermit Fence 1993-4-30
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FENCE PERHIT 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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Job Location: B~~ 010\}o~lQ~ 1 '(\0110 ,._~
Assessors ,Map It:Jf)Q~f).:jL \) Tax Lot It: (J3~CD
O~ner: 6,~~m1lill~ : (-1v:tbs .-
Address:~ Y.\\L\) ~\'( A.~ . ~ Phone It: Pf:f(n-~(cP>3
City: UV1.0 _) State: (\.)~Qrv:Jn_)_ZiP: m~8
Value of Fence:' 4~W Fence perm~t is $5.00
C~ntractor/Installer: lQ~/)fiLU tf ~ ~ ;trfJD'J~,
City:
State:
Zip:
Phone It:
Address:
Construction Contractors Registration It:
Expires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726....)769).1 also staten that all information on
this application/permit is correct and'that I ~as provided ~ith the Springfield
Development code requirements for fence standards.
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\l1g~:Lo()~.r:~_k;;lc_ (?~) Date
fJ . . FOR OFFICE USE
Date of Application: '~. 9q . Ct3
Receipt It ~y ) Issued
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Total Amount Collected: ~J .
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Checked for Delinquencies:
Checked for Historical Status:
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Permit No:. QQ.['f)f'6
Address: _D~'1 T~J(1)9il~(\},fPB
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Issued by: '--U 1 V Date: l'e
.FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: OregDn Law, ORS 701,055(4), requires residential cDnstructiDn permit
applicants WhD are nDt registered with the Construction CDntractDrs 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 frDm registration
under ORS 701.010(7), need not submit this statement. This statement will be
filed with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
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3. A. I I My general contractor is
I own, reside in, or will reside in the completed structure,
I understand that I must register as a construction contractor il the structure is sold
Dr Dffered for sale before or upDn completion.
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
I I will be my own. general contractor,
II I hire subcontractors, I will hire only subcontractDrs registered with the Construc-
tion CDntractDrs 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 nDtily the Dffice issuing this building permit 01 the name 01
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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Signature 01 Permii Appficant
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CONSTRUCTION CONTRACTORS BOARD CJ
0244J 8/91 . .
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Date
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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INFORMATION NOTICE TO PROPERTY OWIRS
ABOUT CONSTRUCTION RESPONSIBILITIES
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NOTE:. This Infor.matiDn Notice to Property Owners About ConstructiDn RespDnsibilities
was develDped by the Construction Contractors BDard in accordance with ORS 701.055(5),
passed .by.the 1989 Oregon Legislature.
If you are 'acting as YDur Dwn contractor lD cDnstruct a new home or make a substantial improilement to an
existing structure, you can prevent many problems by being aware of the iollowing respDnsibilities and areas
of concern.
EMPLOYER RESPONSIBILlTI::S:
If you hire persDns not registered with the Construction CORtractors Board to dD labor in constructing or assisting
,in the construction Dr improvement of a resideRtial structure, you will, in most instances, be ruled to be an
"employer" and the people YDU hire will be "empIDyees". As the .employer, you must comply ~ith the following:
Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at
the time employees are paid. VDU will be liable fDr the tax payments even if you don't actually withhold the
tax from your emplDyees. For more information, call the Oregon Department of Revenue at 378-3390,
Unemployment Insurance Tax: As an employer, YDU are required tD pay a tax for unemplDymeRt iRsurance
purposes OR the wages of all employees. FDr more information, call the Oregon Employment Division DHR
at 378-3224.
WDrkers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' CompensatiDn
Law, and must obtaiR workers' cDmpensation insurance for your employees. If YDU fail to obtain workers'
compensation insurance, you may be subject tD peRalties and will be liable for all claim costs if one of your
employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434.
U.S, Internal Revenue Service: As an emplDyer, you must withhold federal incDme tax from employees' wages.
You will be liable for the tax payment even if YDO- didR'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 be brought t6 your attention through inspections.
liability and Property Damaqe Insurance: Contact your insurance agent to see if you have adequate insurance
cDverage 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 tD Supervise Employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work
Df rough-in and finish trades; and to notify building officials at the appropriate times SD they can perfDrm
the required inspections. .
If you have additional questions. write to:
Construction Contractors Board
700 Summer SI. NE, Suite 300
Salem. OR 97310-0151
Phone 503-378-4621
0244J 10/24/89 .
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