HomeMy WebLinkAboutPermit Fence 1993-03-04clTY oF SPR TVGFIELD, OREGON
225 North Fifth Street
Springfield, Oregon 97417
FENCE PERITT APPLTCATTON
CITY OF SPRINGFIELD
BUILDING SAFETY DTVISTON
SP,rINGFIELE,
0ffice:
INSPECTION LINE:
726-3759
726-3769
Job Location:
Assessors Map #:I Tax Lot #:
Ovner
Address
Ci ty:
e *:
zip:
Val-ue of Fence:Fence Permit is $5.00
Con t rac torlIns taller:
Address:Phone #:
Ci ty:S ta te:Zipz
Construction Contractors Registration #:_Expires:
S tu _Al -q5
Date
FOR OFFICE USE
Date of Application:
#;
Receipt #fssued By:
Total Amount Colleeted:
By signing this permit/applicatiglr-r agree to carr for an inspection once myfence has been constructea (zzo-gle\. "r arso J,","a that all information onthis apprieation/permit i" "oti""t and that r vas provided vith the SpringfieldDevelopment code requirements for fence standards.
Stat
ffi
Checked for Delinqueneie.s: (.__.Checked for Historieal St^trr"(/
Permit No:
Address:
lssued
OR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Fill in he icable blanks, and initial boxes 1 and 2, and either box 3A or 38:
Da
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 plumbingpermits. Licensed Architect and Engineer applicants, exempt from registrationunderORS 701.010(7), need not sudmit this statement. This statement will befiled with the permit.
1 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.
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.
2
3
OR
3 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 willcontract with a contractor who is iegisiered with the Construition Contractors 6oardand I will immediately notify the office issuing this building permit of the name ofthe contractor.
l.hereby certify that the above information is correct and that I have read and understandthe lnlormation Notice to Property Owners about Construction nesponsibilities on thereverse side of this form.
tu 3 4-qbormitppcantDate
CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
WHITE COpy To tssutNc AGENCY PERMIT F|LEPINK COPY TO APPLICANT
INFORIIATION NOTICE TO PROPERTY OVNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation Notice to Property Owners About Construction Responsibilities
was'develop6O Uy the Construction Contractors Board in accordance with ORS 701;055(5),
paqseQ by the.1989 Orqon Legislature.
lf you are acting as your own contractor to construct a new home or make a substantial imprwernent to an
existing structure, you can prevent many problems by being aware of the following responsibilities and areas
of concern. '- - r
EMPLOYER RESPONSI 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 m.ost 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
uwillbeliableforthetaxpaymentsevenifyoudon'tactuallywithholdthe
tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390'
Unemployment lnsurance Thx: As an employer, you are required to pay a tax for unemploy.ment insurance
mployees.Formoreinformation,calltheorqgonEmploymentDivisionDHR
at 378-3224.
Asanemployer,youar.esubjecttotheoregonWorkers,Compensation
Lffikerscompensationinsuranceforyouremployees.lfyoufailtoobtainworkerS'
compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your
e*pioy"". is injured on the job. For more information, call the Workers' Compensalion Division DIF at 573-74U-
U.S. lnternal Revenue Service: As an employer, you must withhold federal ingome tax from employees'wages.
ymentevenifyoudidn,tactuallywithholdthetax.Formoreinformation,call
the lnternal Revenue Service at 221-3960.
-!ge lernplgleg As the permit holder for this proiect, you are responsible for resolving any.failure to meet
..cde requirernents that may be brought to your attention through inspeetions'
Liab and Dam lnsurance:
coverage for acc ents and om ONS SU
tures, fire, or work that must be re-done.
Make sure you have sufficient time to supervise your employees'
Expertise: Make sure you have the expertise to act as your own Eeneral contractor, to coordinate the work
ffi-i. unJlinirn irades, and ro notify buitding officiats at the appropriate timpsnsq 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
0244J 10124189
Contact your insurance agent to see if you have adequate insurance
ch as falling tools, paint overspray, water damage from pipe punc-
Time to Supe rvise Employees