HomeMy WebLinkAboutPermit Fence 1994-07-20C'TY OF OREGO'V
PENCB PBRHIT APPLTCATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRINGFIELO
0ffi ce :
INSPECTTON LINE:
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225 Norrh Fifth StreetSpringfield, Oregon 97477 726-37s9
726-3769
Job Location:LI
Assessors #:
Owner:
Address 3Z 0uo, qF(
Ci ty:F State:08
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l)--Value of Fence:
Cont rac tor/Ins tal1er :
Address:
cityt- state:
Construction Contractors Registration *:
Tax Lot *:
Phone f: Q .t r- q 7 97
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Fence Permit is 95.00
Phone #:
Zip:
Lres:
Xy signing this permit/application, I agree to caII for an inspection once myfence has been constructed (726-3769 ). I also stated that aII information onthi s lication/permit is correct and that r vas provided vith the Springfiel-dt code r ements for fence standards.
)c>
ture Date
FOR OFFICE USE
Date of Application:JOB *:
Receipt #Issued By:
Tota1 Amount Collected:
J+
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Checked for Delinquene'ies:Checked for Historical. Status:
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Permit #:
Address
Issued by:Date:
Statement: lnformation Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exemptfrom registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in appropriate blanks and initial boxes I andZ, and either box 3,A' or 38:
1. I own, reside in, or will reside in the completed structure.
2. 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,. My general contractor is
(Narne) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
38. I will be my own general contractor
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify is correct and thatl have read and dounderstand thelnformation
Construction Responsibilities on the reverse side of this form.
<)-r*
(Signature of permit applicant)
(Whrte copy to issuing agency permit ftle,
pink copy to aPPlicant)
OR
Notice to
(Date)
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Informa{ion Notice to Pfoperty Owners
About Construction Responsibi lities
I
N ot e :. 7' hi s . lntb rmat io n ! otic e. t 9 P rop e rty Ow ne rs. abe ut C o nst r uct ion R e spons ib i
was ievelped by thi {-ottsrruction Contra;1c1t1y Boayt in accordance wirh ORS 70
11 y*tt alc itcting as y$ul'*1vn colltraoxor {(} constnrct a nl: w lrorne or makc a suhstan{ial improvement to an existing stmcture,
you can prcvent many problems by beurg aware of the following responsibilities and areas of concern.
EM PLOYER RESPONSIBILITIES:
If you hirc 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 liabie for the tax payrnents even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945-8091.
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 at the Deinrtrnent of Hupran BEsourcesat378-3524
:
Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and inus{
obtain workers' compensatioil insurance for your employees. If you fail to obtain workers' compensation insurance, you;may
besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. Formoreinformati-on,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liabl6 for the tax payment even if you didn't actually withhotd the tax. For more information, call the Internal Revenue Service
at 1-800-829-1040.
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 requirernentsthatmaybebroughttoyouraftentionthroughinspections.i
Liabitity and property damage'insurance: Contact your insurance agpnt to see if you have a@uate ins6rance coverage for
accidents and omissions such as talling tools, paint overspray, water damage from pipe punctures, fire, q wort that must be
re-done.
:lities
t.0ss(s).
Time to supervise employees: Make sure you have sulTicient time to supervise your employees.
Expertise: Make sure you have the expertise.to act as your own geneial contractor, totoordinate the work of rough-in and finish
trades, and to notify building officials at the appropriate times so they can perflorm the required inspections.
If you have additional questions, write or call the Construction Contractors Boatd(Po Box 14140, Salem, OR 97309-5052,
503/378-4621). The Board is locared at 700 Summer st. NE Suite 300, in salem.
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