HomeMy WebLinkAboutPermit Fence 1995-03-28t/
225 North Fifth StreetSpringfield, 0regon 97477
FENCE PBRHIT APPLICATION
CITY OP SPRINGPIELD
BUIIDING SAFETY DTIIISTON
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INSPECTION LINE:
726-37s9
726-3769
Job Location:g
1oAssessors M.p *,3z L Tax Lot #:
Ovner:
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Address:
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Value of Fence: Z OL
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Con trac tor/fns taIIer:
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Fence permit is g5.OO
Phone *: tl tl t 4o 0
State. Cl K zipz (f V 't 1
Ex pires:
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Construction Contractors Registration #:
By signing this permit/application, Ifence has been constructiir fZzo_s769),this_ applicatlonzpermii -i; ;;;;;ct andDevelopment code requirements for fenc
agree to call for. an inspection once myf also stated that aII i"forr"tion on
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that I ,1" provided ,iin-tr,"-iiringfierde standards.
S ure z^)s^'i{Date
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FOR OFF
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ICE USB
qDate of Application:
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Receipt # :(U 1b.\
TotaI Amount Collect
JOB {f:
Issued By
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aC'TY OF OREGO'U
Chbcked for Delinqueneies:
5
Checked for Historical Status:
3
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Permit #:O
Address:nL& N. [o +L sr.
Issued by:N.rnrcu^dA Date:3-2x-? s
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, mechnnical, and plumbing permits. Licensed
architect and engineer applicants, exemptfrom registration under ORS 701.010(7),
need not submit this statement. This statement witl be filed with the permit.
Fill in the appropriate blanks and initial boxes I and2, and either box 34 or 38:
l. I own, reside in, or will reside in the completed sffucture.
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,{. My general contractor is E itr
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
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 noti$ the office issuing this building permit of the
name of the contractor.
Ihereby certify that the above information is correctand thatl have read and do understand the Information
Owners about Construction Responsibilities on the reverse side of this form.
3-2 8^q
(Signature of permit
(White copy to issuing agency perrnitfile,
pink copy to applicant)
q
Notice to
(Date)
fu-"SS
-I
will be my own general contractor.
|-/
Inforrnation Notice to Property Owners
About Construction Responsibilities . '
Note: {lzis lnJttrrnation Noti<'t to Pr(,ferty Owners ubout {'onstrut'tion Responsibilities
yt'cs devt;loped bt,the Construc:tion Contrc,ctors Benrrl in ac'crtrdance with ARS 70 1.055(5).
I{'y6u iue acting as your owrl con{ractor t(, construcl a new home or make a substantial improvement to an existing structure,
you can prevent many-p.fpblems by being aware of the following responsibilitias and areas of conqern.
EM PLOYER RESPONSI BILITIES:
If you hire persons not [egi$tq,red gith,the Constructipn Collractors Bqard to do labgr ry-r cgg.q{{uctllg gr assisting in the
construction or improvement of aresidential struqture, you will, in most inslances, Ue rul.ed to be ap employer and the people
you hire will be employeeq. As the employer, you must comply with the {o[owing:
Oregon,s withhblding thx law: As an employer, you must withhold income taxes from emplo-yee W?igep at thl time employees
are p"aid. you will beliabte for the tax payments even if you don't actually withhold the'tax from your employees. For more
information, call the Oregon Dept' of Revenue at 945-809 t . i ' ;') :
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
*ug", of utt employees. For more information, call the Oregon Employment Division at tlre Depa*rnent of Htunan:-Bbsoirrtpt
at378-3524
Workers, compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and hrust
obtain workers' compensation insurance for your employees. If you fail to obtain workers'lo-rylTtio] insurance, you.Try
u" ,utiect to penalties and will be liable for ail claim cosrs if one of your employees is injured T th" joll laT:re informalion,
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 eniployees' wages. You will be
liable forthe tax payment even if you didn'iactually withhold the tax. For more information, call the Internal Revenue Service
at 1-800-829-1040.
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 requirernents
that may be brought to your aftention through inspections'
Liability and property damage insurance: contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as talling tools, paint overspray, water damage fiom pipe punctures, fire, or work that must be
re-done.
Time to supervise employees: Make sure you have sufficient time to supervise your emptoyees'
Expertise: Makesureyouhavetheexpertisetoactasyourowngeneralcontractor,tocoordinateth.eworkofrough-inandfmish
t.ui"*, ancl ro notify uuitalng officiats at the appropriate times so they can prrform the required inspections.
lf you have additional questions, write or call the Constru;l.ion Contractors Board (PO Box l4l4},Salem, OR 97309-5052,
SOV?f.A-+AZ|). The Board is located at 700 Summer St. NE Sr"rite 300, in Salem'
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