HomeMy WebLinkAboutPermit Fence 1993-02-12i
225 North Fifth Street
Springfield, Oregon 97477
FENCE PERHIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRINGFIELED
0ffice:
INSPECTION L]NE:
726-3759
726-37 69
CITY OF SPR"VGFIELD OFEGO'U
Job Location:4z r--, 'Tt-rr,rv irA'-^ uAssessors Map *: ltr O 20 '- Zl Tax Lot #: U4 OD
Ovner:
Address:z/>;-fun", s7 Phone #:
Ci ty:state,%zip, ?717')
VaLrre of Fence:Fence Permit is $5.00
Contractor/Ins taller :
Address:Phone #:
Ci ty:State:Zip:
Construction Contractors Registration #:.Expires:
By signing this permit/application, I agree to caII for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this applieation/permit is correct and that I vas provided vith the Springfield
Development code requirements for fence standards.
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FOR OFFICE USE
Date of Application: 2 -/ Z -7 3 JOB *:
Receipt *Issued By:
Total Amount Collectedl. 6 QL
Checked for Delinqueneies: \-- Cheeked for Histor:ieal Status:
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R OFFICE USE ONL
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERSABOUT CONSTRUCTION RESPONSIBTLITIES
Note: Oregon Law, ORS 701.055(4) ,. requires residential construction permitapplicants who are not registereO witn the Construction Contractors Board tosign the following statement before the building permit can be issued. This state-ment.is required for residential.building, elec[rical, mechani.if,-inO plumbingpermits. Licensed Architect and Enginelr applicants, exempt from registratioiunderORS 701.010(7), need not sudmit thid btatement. Thib statement wiil befiled with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
Permit No:E ')
<,-
Address:
lssued Date: 2 -22 f3
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 soldor offered for sale before or upon completion.
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
1.]:
2.,]=:-1
3.A My general contractor is_
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.EJ 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 inlormation is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
a--
gnature rm pp cant
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
o-Aa
INFOHM}rfION NOTICE TO PROPERTY OWI'r€RS
ABOUT CONSTRUCTION HESPONSIBILITIES
t,loTE; This lnformation Notice to Property owners About construction
*** Ouu"ioppd bt the Construction Contractors Board in accordance with t
-passed by th-q '1989 Oregon Legislature.
Responsibilities
oRs 701o55(5),
I
lf you are acting as y*ui own contractor to construct a new home or make a substantial improvement to an
existing structure, you can prevent many problenrs by being aware of the following responsibilities and areas
of concern.
EMPLOYER RESPONS!BILITIES:
lf 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 peopie you hire will be "employees". As the employer, you must comply with the following:
on's Withholdi Tax Law: As an employer, you must withhold income taxes from employee wages at
the time em oyees are paid. You will be liable for the tax payments even if you don't actually withhold the
tax from your employees. For rnore information, call the Oregon Department of Revenue at 378-3390.
Unernployment lnsurance Tax: As an employer, y0 u are required to pay a tax for unemployment insurance
information, call the Oregon Employment Division DHRpurposes on the wages of all employees. For more
at W8-3224.
1l_orkers' Cornpensalgllrygrygq-: As an employer, you are subiect to the Oregon \A/orkers' Compensation
uaw, anO 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 all claim costs if one of your
employees is injured on the job. For more information, callthe Workers' Compensation Division DIF at 973-74U.
U.S. lnternal Revenue Service: As an ernployer, you must withhold federal income tax from employees'wages.
Vou will be liable for tne tax payment even if you didn't actually withhold the tax. For more information, call
the lnternal Revenue Service at 221-3960
OTHE* RHSPONSI3ILIT'E$ ANN AHEAS OF CONCERN:
-r:de Co mpliance: As the permit holder for this project, you are responsible for resolving any failure to meet
ade requirements that may be brought to your attention through inspections.
LiabilityanContactyourinsuranceagenttoseeifyouhaveadequateinsurance
eoverage for accidents and ornissions such as falling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re-done.
Ig1gjg_$lpg_Iylgs Fmployees: hllake sure you have sufficient time to supervise your employees.
Expertise: Make $ure yolr have the expertise to act as your own general contractor, to coordinate the work
of rough-in and finish trades, and to notity building officials at the appropriate times so they can perform
the required inspections. . - i)
lf you have additional questions, write to:Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
4244J 1A124189