HomeMy WebLinkAboutPermit Fence 1992-06-12FENCE PERHIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SATETY DIVISION
SP|lITTIGFIELE,
0ffice:
INSPECTION LINE:
f
225 North Ftfth Street
Springfield, Oregon 97417
726-3759
726-3769
CITY OF SPP"VGFIELD, OFEGO'V
Job Location:
Assess
0vner:
ors Ma p #:
Address:
Ci ty:
Tax Lot #:
Phone {l:
State:Zip:CIt\tl
\oDValue of Fence Fence Permit is $5.00
Con t rac tor / Ins taIler :
Address:Phone S:
Ci ty:State:Zipz
Construction Contractors Registration #:Expi res : _--
By signing this permit/application, I agree to caII for an inspection once my
fence has been constructed (726-3769). I also stated that aII information on
this application/permit is correct and that I r,ras provided vith the Springfield
Development code requirements for feuce standards.
?O
na ture Date
FOR OFFICE USE
Date of Applicati JOB *:
Receipt *
Total Amount Collected:
ssued By:
-\x
Checked for Delinquencies:
@
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LN
I orieal ta S:
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Permit No:
Address:
lssued Date:
OR 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-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
underORS 701.010(7), need not submit this statement. This statement will be
Fiil
1.
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 ,
Contractor registration numb
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3.8 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 Gonstruction Responsibilities on the
reverse side of this form.
ignature t p can
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
th
ith the permit.
plicable blanks, and initial boxes 1 and 2, and either box 3A or 38
I own, reside in, or will reside in the completed structure.
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
f iled
n/t-fi-
Datb/
s
INFOFtntA?,tON NOTICE TO PROPERTY ClwfvcRs
ABOUT CONSTRUCTION RESPONSIBILITIES
i t, i ,'' '. '.'t::tlf yodare'actinE as yow ouln c.orTtractorto construct a new home or make a substantthl
existing structure, you can prevent many problems by being aware of the following respon
of concern '. )'
ust be re-done.
improvement to an
rsibilities and areas
EMPLOYER RESPONSIBILITIES:
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, y'ou 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 Withholling Tax Law: As an employer, you must withhold income taxes from employee wages at
the time employees are paid. You will 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 ol Revenue at 378-3390.
Unem ent lnsurance Tax: As an em ployer, you are required to pay a tax for unemployment insurance
purposes on the wages all employees. For more information, call the Oregon Employment Division DHR
a|378-3224
'yqlqq_Qgrnpglqation lnsurance: As an employer, you are subject to the Oregon Workers' Compensationt-awpensationinsuranceforyouremployees'ityoufailtoobtainworkers'
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 gf?14A.
U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages.
ymentevenifyoudidn,tactuallywithholdthetax'Formoreinfoimation,iall
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
-i99-a9rp!3!9e: As the permit holder for this project, )ou are responsible for resolving any failure to meet
:ode requirernents that may be brought to your.attention through inspegtions.
Liabi and lnsurance: Contact your insurance agent to see if you have adequate insurance
coverage for accidents an
tures, fire, or work that m
omissions such as falling tools, paint overspray, water damage from pipe punc-
Time to Supervise Em ployees Make sure you have sufficient time to supervise your employees.
Expertise: Iitlake 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.
lf you have additional questions, write to:Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
NOTE; This lnformation Notice to Property Owners About Construction Responsibilities
was developedbythb Qonstruction Contractors Board in accordance with ORS 701055(5),
passed by the 1989 Oregon Legislature.
0244J 10t24t89