HomeMy WebLinkAboutPermit Fence 1994-08-11OREGO'VCITY OF
225 North Fifth StreetSpringfield, Oregon 97477
PBNCE PERHIT APPLICATION
CITY OF SPRINGFIBLD
BUII.DING SAFETY DIVISION
SPRIIrlGFIELO
0ffi ce:
INSPECTION LINE:
726-3759
726-3769
Job Location:(zq ....- /"e-
Assessors M.p #t 321 73t'7 0
owner | y'}[ 't Cl,nrr'hu G,'b".^t
Tax Lot *:OCJ
Address, /{2? 5e7aai *-.-Phone #: '7 z- 6 " 11' 9-
Ci ty:f,; i,/State: C2P.zip:?zyz7
Value of Fence, 4aOry
Contractor/Installer: fe/f
Fence Permit is 95.00
Address:
Ci ty:State:
Construction Contractors Registration #:
S ture
Phone #:
zip:
Expi res :
an inspection once myhat all information on
ded vith the Sprlngfield
8- //- /{
Date
By signing this permit/application, I agree to call forfence has been constructed (126-3769). r arso stated tthis apprication/permit is correct and thatrr "."-fro"iDevelopment code requirements for fence standards.
FOR OFFICE USE
Date of Application
Receipt #
TotaI Amount CoIlected:
JOB *:
Issued
ll-
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Checked for Delinqueneies:
5.od
Checked for Historieal. Starus:
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Permit #:
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Issued by:"""t
Rddress:/5
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Statement: lnformation Notice to Property Owners
About Construction Responsibilities
Note: Oregon Inw, ORS 701.055(4), requires resifuntial 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, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exemptfrom registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and2, and either box 34. or 3B:
5(fu^,reside in, or will reside in the completed structure.
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
(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
K 38. I will be my own general contractor
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 notify the office issuing this huilding permit of the
name of the contractor.
I hereby certify thatthe above informationis correct and thatl have readand dounderstand thelnformation
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
94/- 7/
(Signature of permit applicant)
(White copy to issuing agency perrnit file,
pink copy to applicant)
(Date)
)
Zl z, L/r'//"+
Information Notiee to Property Owners
About Sonstruction Responsibilities
N*l*.,"' Tkis lnJrrrrcwtion&orice tts t')rr;Sterly Owtwrsafx)#r [-#$"!'{rr{{:tionffes;rcnsi&il ,rr"i
u'ezs ,:/cle /r;putl !7y rl'it) Cons!r urtiort {ottir-ttt.:trtrs f***rd rr er."r:ilir/r*ryce n,ir,fu Sr?S IilJ.$55(5].
if yor: are acting as y{}L}r *wr} ror}trae tsr t{.1 rl:$strucl ;t n*rv hr:r,re *r *rake a subslantial in:pr*vement to an *xisting structurc,
you cam pre vent many problemx by berng aware of the foliowing responsibilities and areas of concern.
EM PLOYER RESPON$IBILITIES:
If you hire persons not registered witlt thc Conslruction Contractors Board to do labor in consuucting or assisting in the
constmrction nr impr*veruent cf a rosidential struc{utre, you rvill, in most instances, be ruled to be a:r employer and the people
you hire rvitrl L:e ernployees. As the erxploy*r, yo!.i rnust corrply with the following:
Oregon's withhclding tax law: As an employer, you must withhold ine ome taxes from employee wages at the time employees
are paid. Ycu will be liahle for the fax payments even if you don't act*ally withhold fhe tax from your employees. For more
information, call the tlregon Dept. of Revenue at 945-8091 .
Unemployment insurance tax: As ar: ernployer, you are required to pay a tax for unemployment insuranc€ purposes on the
wages of all employees. For more information, call the Oregon Employment Division at the I),epartment of Human Resources
at378-3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and must
obtain workers' compensation insurance for your employees. If you fail to obtain wotkers' compensation in$urance, you may
be subject to penalties and will be Iiablc forall claim costs if one of youremployees is injuredon ihe job. Formore information,
call the Workers' Compensation Divisian at the Department of Consurner and Businriss Services at 945-7888.
U.S.Internal Revenue Service: As an employer, you must withhold federal income tax from ernployees''wages. You will be
liable for the tax payrnent even if you didn't actually withhold the tax. For more information, call the Intemal Revenue Service
at t-800-829.1040.
OTHER RESPON$IBILITIES AND AREAS OF CONCEHN:
Ctde compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requiremgnfp
that may be brought to your attention threiugh inspections. :
_.rl.' ,
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools, paint overspray, water damage from prpe punctures, fite, or work that must be
re-done.
'fime to supervise ermployees: Make sure yr:u have suf{ici*nt 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 nr:tify huilding officials a{ the appropriate times so they can perform the required inspections"
If you have additional questions, write or call the Construction Contractors Board (PO Box -141,40, Salem, OR 97309-5052,
5Ay378-4621)" The Board is located at 700 Summer St. NE Suite 3ff), in Salem.
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