HomeMy WebLinkAboutPermit Fence 1993-01-25225 North Fifth Street
Springfield, Oregon 97477
FENCE PERHIT APPTICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRINGFIELD
0ffice:
INSPECTION LINE:
726-3759
726-37 69
CITY OF SPB OREGON
Job Location: Z?, 6 t/ ,t ta"r i^n crr ^* kt,(rb
Assessors Map #:Tax Lot #:
0vner:-Po^-t €zs ntftr+
Address:
Ci ty:
7t r{,\/, ahlvv(rv\t^/- -A60 Phone #: 1 t+1 - 3q >g
SpFd State:0t'L Zip: q11171
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Fence Permit is $5.00
Cont ractor/Ins taIIer :
Address:Phone fr:
Ci ty:State:Zipz
Construction Contractors Registration *: Expires:
frl,.l nv,r/
rmit/apprication, r agree to carr for an inspection once mystructed (726-3769). r also stated that alr information onermit is eorreet and that r vas provided with the springfield
equirements for fence standards.
By signing this pe
fence has been con
this applieation/p
Development eode r
eZr ,/- .?s'--73
S ture Da te
FOR OFFICE USE
Date of Application: I - Lb -q
Receipt *')
Total Amount Colleeted:dD
JOB #:
Issued By:ff-"rr---<
Checked f or Delinquene'ies: ./
4
Checked for Historical Starus:
Value of Fence:
Permit No:Qeoog-t
Address:.(.til $L \rtv*
tssued ov, Ll.,4w-A. Date: in5'1\
1
2
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
underORS 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.
Contractor registration numbe
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
3.B 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 certily that the above information is correct and that ! have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side ol this form.
/ - 2{*,^7 -.'-\
gnature of rmit pp cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLIOANT
OR
/
INFORTUATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation Notice to Property Owners About Construction Hesponsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the.J989 Oregon Leglslature.
!,-
lf you are actfng as your own contractor to construct a new home or make a substantial imprl!{iement to an
existing structure, you can prevent many problems by being aware of the following responsibilitigs and areas
of concern.
EMPLOYER RESPONSIBILITIES:
lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting
in the construction or imprwement of a residential structure, you 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 Withholding 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 pgyments even if you don't actually withhold the
tax frorn your employees. For more information, call the Oregon Department of Flevenue at 378-3390.
Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment Division DHR
at 378-3224.
Workers' Compensation lnsurance: As an employe; you are subject to the Oregon Workers' Compensation
Law, and must obtain workers' compensation insurance for your employees. lf you fait to obtain workers'
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, call the Workers' Compensation Division DIF at W3-7434.
U.S. lnternalRevenue Service: As an employer,yo u must withhold federal income tax from employees'wages.
will be e e tax payment even i fyo ud idn't actually withhold the tax. For more information, call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet
code that may be brought to your attention through inspections.
Liability and Property Damage lnsurance: Contact your insurance agent to see if you have adequale insurance
coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re-done.
Time to Supervise Employees: Make sure you have sufficient 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 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
0244J 10t24t89