HomeMy WebLinkAboutPermit Fence 1992-7-31
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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
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Job Location: 'T\ 1'-"\
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Address: 44nq ~o.l m j fl).
City:~rQ /
Value of Fe~e: JJ rrrJr;D
ContractorlInstaller: (\ 1)1\ Q Jf)
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Tax Lot #:
f)4(- O'7l~1} ~
Zip: ql4-1~
Phone #:
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State:
Fence Permit is $5.00
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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.
inspection once my
all information on
with the Springfield
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Da toe I
FOR OFFICE USE
Date of Appl~cation: 1(.0\ ,qQ....
Receipt # ,~~
Total Amount Collected: 5.00
JOB #: Q'.mlFf) ~
Issued By: ~~
Checked for Delinqupnr.i es:
Checked for Historic~l St~tus:
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Permit No: ~
Issued by: I/YV
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) Date: ~-
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 forresidential 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 {JPlicable blanks, and initial bDxes 1 and 2, and either box 3A or 3B:
1. ~ I own, reside in, Dr will reside in the completed structure.
2. I I I I understand that I must register as a construction contractor if the structure is sold
I Dr Dffered for sale befDre Dr upDn cDmpletion.
3. A.I
I My general contractDr is
ContractDr registration number
I will instruct my general contractor that all subcontractors WhD work on the struc-
ture must be registered with the Construction Contractors Board.
OR
I will be my Dwn general contractor.
3. B.
If I hire subcDntractDrs, I will hire only subcontractors registered with the Construc-
tion ContractDrs BDard. If I change my mind and do hire a general contractor, I will
cDntract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the Dffice issuing this building permit of the name Df
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
m..m..ld. .1 !hI. I'~.k; ;/3 j; y
Ignature of Per t Applicant l1late
CO STRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
,
INFOIIATION NOTICE TO PROPERTY !NERS
ABOUT CONSTRUCTION RESPONSIBILITIES
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NOT~:' . ,..' Thi~~riJcir~ation Notice tD Property Owners About ConstructiDn Responsibilities
; wa~"drvelcipe~ by t~~ P?/lstruction Contractors Board in accordance with ORS 701.055(5),
pa'ssedby\thEl 1989 O,rElgon Legislature.
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If YDU are acting as your Dwn contractDr tD construct a new home or make a substantial imprDvement to an
existing structure, YDU can prevent many problems by being aware of the fOIlDwing respDnsibilities and areas
of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persDns not registered with the ConstructiDn ContractDrs Board tD do labor in constructing Dr assisting
in the cDnstruction or improvement of a residential structure, you will, in most instances, be ruled to be an
"employer" and the peDple you hire will be "employees". As the employer, YDU must cDmply with the follDwing:
Oregon's WithhDlding Tax Law: As an employer, you must withhold income taxes from emplDyee wages at
the time employees are paid. You will be liable for the tax payments even if YDU don't actually withhold the
tax from your emplDyees. For mDre infDrmatiDn, call the Oregon Department Df Revenue at 378-3390.
Unemployment Insurance Tax: As an employer, you are required to pay a tax fDr unemployment insurance
purposes on the wages of all emplDyees. FDr more information, call the Oregon Employment Division DHR
at 378-3224.
WDrkers' Compensation Insurance: As an employer, YDU are subject to the OregDn WDrkers' Compensation
Law, and must obtain workers' compensation insurance for your emplDyees. If you fail tD obtain wDrkers'
compensatiDn insurance, YDU may be subject to penalties and will be liable for all claim costs if one of YDur
employees is injured on the job. For more infDrmation, call the Worker~' C~mpensation Division DIF at 373-7434.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from emplDyees' wages.
You will be liable for the tax payment even if YDU didn't actually withhold the tax. FDr 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 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 tODls, paint Dverspray, water damage from pipe punc-
tures, fire, or work that must be re-done.
Time to Supervise Employees: Make sure YDU have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as YDur own general contractor, tD cDDrdinate the work
Df rough-in and finish trades, and tD nDtify building officials at the appropriat~ times so they can perfDrm
the required inspections. ','
If you have additiDnal questions, write to:
Construction CDntractors BDard
700 Summer SI. NE, Suite 300
Salem, OR 97310-0151
PhDne 503-378-4621
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0244J 10/24/89