HomeMy WebLinkAboutPermit Fence 1991-11-8
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SPRINGFIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
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Assessors Map It: } fo 'Z-OfJ Il..f
Owner: VOA/e....... 1< csl-VV2Ar
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Job LocatiDn:
Tax Lot It: / f? ib
Address: 102..:2.___
City: sI-id
State:
Phone It: 7 bib CZF6k>
Zip: q7if-7fl
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Value of Fence: ~. oz)
Fence Permit is $5.00
Contractor/Installer: C)W~V
Address: Phone It:
City:
State:
Zip:
Construction Contractors RegistratiDn It:
Expires:
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.
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Signature
. FOR OFF ICE USE
Issued By:
Job It: tJ/L-;)-vt.
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Date Df Application:
. Receipt It: ~
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Total AmDunt Collected: ~.C52:)
Checked for Delinquencies: ~ Checked fDr HistDrical Status: ~
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Permit No: q / /7.JJ
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-Addr~ss: lozz. LM~ f!-t'cfO}L-
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Issued by:a~ Date: II-YQj
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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.
mentisrequired 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 boxesl'and 2, and either box 3A or.3B:
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1. I V) I I own, reside'in, or will reside in the completed structure.
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3. A.I
, ,I understand that I must register as a construction contractor if the structure is sold,
.or offered for sale before or upDn completion.
I My general contractor if'
2., ,.
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
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Y' I I will be my own general contractor.
If I.hire subcontractors. I will hire only subcontractors registered with the Construe.',' .
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 i1boutConstruction'Responsibilities on the'
reverse side of this form. ~
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. Signature of ,~erfi1if Applicaili
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Date" ,
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
Pt~~HFFE COPY TO ISSUING AGENCY PERMIT FILE
UI1 pBINK-COPY TO APPLICANT
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INFORlTION NOTICE TO PROPERTY ~ERS
ABOUT CONSTRUCTION RESPONSIBILITIES
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NOTE: This InformatiDn Notice to Property Owners About Construction Responsibilities
was developed by the ConstructiDn 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 ContractDrs Board to do labor in constructing or assisting
in the constructiDn 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 ~omply with the follDwing:
Oregon's Withholding tax Law: As an employer, you must withhold income taxes from employee wages at
the time employees are p'aid. You \(ViII 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 OregDn Workers' Compensation.
Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers'
compensatiDn 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 emplDyees' wages.
You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call
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the Internal Revenue Service at 221-3960. . .' . - ..'-
OTHER RESPONSIBILITIES AND AREAS OF CONCERI':J:
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 _ ihrciugh inspectio.ns..
Liability and Property Damage Insurance: Contact your insurance 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 Super.vise Empioyees: 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.
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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