HomeMy WebLinkAboutPermit Fence 1993-11-09225 North Fifth Street
Springfield, Oregon 97477
FENCE PER}IIT APPLICATION
CITY OF SPRINGFIBLD
BUILDING SAFETY DIVISION
SPRINGFIELD
0ffice:
INSPECTION LINE:
726-3759
726-3769
OREGO'UCITY OF
Job Location:Zlqs tD nl "r,o',n-, ATr"-f,
Assessors Map *:
0vner:
c-t1 a2 3t ,t3 Tax Lot *: OA I OO
c a.-)rvlc Du*c^,LL
Address:Phonef: 1ry+ )qtrl
city: l}.C.r, taa 1".-[rl Statet O Q zipz Q)V1 I
Value of Fence:c OU Pence Permit is $5.00
Con t rac torlIns taller:
Address:Phone *:
Ci ty:State:zip:
Construction Contractors Registration *: Expires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information onthis applieation/permit is correct and that f vas provided with the Springfield
Development code requirements for fence standards.
lt
S re Date
FOR OFFICE USE
3
Date of Application:"Ir, lo^
Receipt #
tot *z QZI bQ G
'sBIssued By:
Total Amount Collected: f
clrecked for Delinqueneies: ,-/' check.ed for Historieal. Status:
() t, rv\ o t./
lflq q
c
Permit No:
Address:
lssued by
3fq3 O.rv<ctaln-\t-,
0g ',/q /r,'7
--T
Date
1
2
R OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONS!BILlTIES
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 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 38:
I own, reside in, or will reside in the completed structure.
I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
A My general contractor is ,
Contractor registration numbe
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
3.8 I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. lf 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 lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of this lorm.
ll-?'t,,
ure o p cant Date
CONSTRUCTION CONTRACTORS BOARD
o244J 8191
3
OR
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
qvtLqb
v"
INFORMAiION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701055(5),
passed by the 1989 Oregon Legislature.
lf you are acting as your own contractor to construct a new home or make a substantial improrrement to an
existing structure, you can prevent many problems by being aware of the following responsibilities and areas
of concern.
EMPLOYEB RESPONSIBILITIES
lf you have additional questions, write to Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
lf you hire persons not registered with the Construction Contractors poard-to do labor in constrqgting or assisting
in the construction or'lhhlprovement of a residential structure,'.ygy will, in most instan-c-es, Ue'ruled to be an
"employer" and the iieoplii you hire will be "employees". As the'emplbyer, you must'comilty Witn tne following:
Oregon's Withholding Tax Law: As an employer, yo, rnr"i'withhold'income taxes from employee wages at
the time employees are.paid,. You will be liable for the lax payments even if you donft actually withhold the
tax from your employees, For more information, call the Oregon Department of Revenue at 378-3390.
Unemployment ESqlqlgg_fax: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of all er,r,rplo!€es, "For more inlorrnation, call the Oregon Employrilent Division DHR
a|378-3224.
Workers' Compensation lnsurance: As an'employer, you are subject to the Oregon Workers' Compensation
Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers'
compensation insurance, you may be subject to penalties and will be.liable for a{ blaim costs if one of your
employees is injured on the job. For more information, callthe Workers' Compensation Division DIF at 573-7434.
U.S. lnlgl!"ral flevenue Servicq; As ?n emplgyer,.you must withhold federal income tax from employees'wages.
mentevenirvoididn't,actua1r!,withho1dthe.tax'Fo1moreinfoimation,call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONGERN:
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.
:'
Liabil and lhsurance: Contact your insurance agent to see if you have adequate insurance
coverage accidents and omissions such as falling tools, paint overspray,'water dhmage 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.
o24N 10t24189