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Home My WebLink AboutPermit Fence 1992-3-3 '~ . . FENCE PERMIT APPLICATION' , , ,CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 Fifth Street. Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769' Job Location: I ~Z LauJnr~c&,c..-Ave.-; V Assessors Map II: \ 1(') -=<. ::Jc::. ")') Owner:' Kay ()~i Its '.,' , ' Address: l~~?_ i~(UUn1/ltts0 ftuc City: ~'I v,q,r...: .I'.ioZ State: (~ . , , , , Tax Lot II: n.~ln() Phone II: Ill;. ?,jy / 01< Zip: 0/471. ~,.....,--, C :00, Value of Fence: t tJ Fence Permit is $5..00 Contractor/Installer: 7~ HV1{' 0 (1...A-/ <, J:2., c::., w ~Q II:QV Phone II: '2,L/<;- !l9oS Zip: q,'-fO';) Expires: . 7!:J..72.,.ls:;J.. Address: City: C J,/ "l/./V> J con;truct~on 1?ont~actors State: ()Q Registration II: 'J19J::[]' By signing this permit/application, I agree to'call for ,an inspection once my fence has been constructed (726-3769). I also state that all information on this application/permit is correct and that I was provided with the Springfield Development Code requirements for fence standards. ~"t"&p~ ~ h )q~ Uate " FOR OFFICE USE, , Date of Application: ,?:)J').., \c,:l.... Job II: C1 :;;L n =< ;:;) c:- Receipt 6: ~C:;:;9,y (JA Issued By:' Total Amount Collected: c:; () () Checked for Delinquencies: Checked for Historical Status: " .. .;.~ ...~' . . Permit No: CJ ') (J :(:j " Address: I~::<":.J Lo..A~^" v,cfu 0 Issued by: aJ~ ,Date: ~/:>.,1cn I 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 statementbefore 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 with the permit. . _ . Fill in the applicable blanks, and initial boxes 1 and 2, and either.box 3A.or 3B: ./ ',1. I 'y. I I own, reside', iri; or will reside in the completed structure. /' ' .. '., .,. ,2.' I 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 ...Yi My general contractor is ~..1 .Lf/\r:;p or,,,^-,,, ~ k-1/\"'IGQ.....- . Contractor registrationnumber'=> J q n I ' , 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.l I I will be my own general contractor.' .,...... . If I hire sllbcontractors, 'I wil1'l1ire'onlysubcontractors registered with the Constrac-' '. , 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. C~~d~ Sig'nature of Permit Applicant J 3/2..)"'11. Date - CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT IN FOliATION NOTICE TO PROPERTY ~NERS ABOUT CONSTRUCTION RESPONSIBILITIES / . ,- ... NOTE: This Information Notice to Property Owners About Construction Responsibilities was developed by the' Construction Contractors Board in accordance with ORS.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 Insu'rance 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 Or~gon 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 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 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, requireme'1ts,that may be brought to your attention througliinspections. Liability and Property Damage Insurance: Contact your insurance agenHo 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 time to supervise your employees. -,' 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. I' 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 .