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Home My WebLink AboutPermit Fence 1993-04-08SPAII{GFIELO FENCE PERHIT APPLICATION CITY OF SPRTNGFIELD BUIIDING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 0ffice: INSPECTION LINE: 726-3759 7 26-37 69 C,ITY OF SPR"UGFIELD OREGO'V Job Location: Assessors Map #:Tax Lot #: 0wner: Address:Phone *: Ci ty:State Zip: Value of Fence:Fence Permit is $5.00 Con t ractor/Ins taIIer : Address:Phone #: Cityt state:Zip: Construction Contractors Registration #:Expires: By signing this permit/application, I agree to call for an inspection once my fence has been constructed (726-3769). I also stated that aII information onthis application/permit is correct and that I was provided vith the Springfield Development eode requirements for fence standards. (.,4- r-2s Date FOR OFFICE USE Date of A Receipt # pplication:JOB *: Issued By TotaI Amount Collected: CD t Checked for Delinquene'ies:Checked for Historieal. Status: D\t()t Permit No: Address: lssued by 1\n6+l\nO,. \3Yc1N ,'FhNtLi 1 2 Date R 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 under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: 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 sold or offered for sale before or upon completion. 3 A 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. 3.8 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 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. OR gnature m t pli CONSTRUCTION CONTRACTORS BOARD o244J 8191 4-,?-73 Date WHITE COPY TO ISSUING AGENCY PERMTT FILE PINK COPY TO APPLICANT /..<- +.8ffi INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnforr_nation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989. Oregbn Legislature. lf yOu dI6'acting''". yow own cbntractor to construct a new home or make a substantial impfovement to an ex'lsting structure,, Jotcqn-prgyent many.prob!9ms Oyloeing aware of the following responsibilities and areas of c-oncgrn - .:, rj,r : , !.1 r :: ' ' i: ' ti.i'"..'. i''"-:. EMPLOYER RESPONSIBILIT}ES: - ::jr 'ri til '' i1:' lf you hire persons not registered with the Construction ContraClOrs Board to do labor in constructing or assisting in the constrijbiion or irilproveme)nt of a residehtiti! stiuaur6,.you wtll,-in most instances, be ruled to be an "emptoyer" alStnel"obi"'vo, hir:i witiioe ::employeeil,ir tne emFrbver, yort*ust comply wilh the following: ., :-:, . 'l o,egq@As.?nemployqroyourDustwithtoidincometaxeSfromemployeewageSat uwittb'eliableforthe1axpayrnentseVenifyoudonitactudlywtthholdthe tax from your employees. For more information, call the Oregon Department of-BevBnu-e.at 378'3390. Unemployment lnsurance Tax: ''As an employer, you are required to pay a tax for unemploymenl insurance rnployees.Forrnqainfor.rnation,calltheoreggnErnploymen1DivisionDHR at 378-3224. i..r) Workers' Compensation lnsurance: As an employet you ar€ subiect to the Oregon Workers' Compensation pensationinsuranceforyouremployees.lfyoufai]toobtainworkerS, compensation insurance, you may be subject to penalties and will be lidble for all claim costs it one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF a|373-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. menteveftifyoudidn'tactual]ywithholdthetax.Formoreinformation,call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCEFN: Code Compliance: code requirements lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 50*3744621 As the permit holder for this project, you are responsible for resolving any failure to meet that may be brought to your attention through inspections. ' Liability and Property Damage lnsurance: Contact your insurance agent to see if you have adequate insurance chasfallingtools,paintoverspray,waterdamagefrompipepunc- tures, fire, or work that must be re-done. ,.: Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. 1 _: Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work oiiougEjn and finish trades, and to noti.ty building officials at the appropriate times so they can perform the required inspections. a244J 10t24t89