HomeMy WebLinkAboutPermit Fence 1992-11-13CITY OF SPR"VGFIELD, OREGO'V
225 North Fifth Street
Springfield, Oregon 97477
FENCE PERI{IT APPLICATION
CITY OF SPRINGFIELD
IIUILDING SAFETY DIVISION
SPEI]{GFIELO
0ffice:
INSPECTION LINE:
726-3759
7 26-31 69
Job Location:
Assessors Map #:
0vner:
Address:
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t
Tax Lot #:
Phone #:ab- b
Zi p, q?V71State:
6Val-ue of Fence:Fence Permit is $5.00
Plrone +, 7 Ab - LG Vs
Ci ty:Srate , D B,zip,Sa 9 ) ?
Construction Contractors Registration *:Expires:
By signing this permit/apptication, r agree to ca1l for an inspection once my
fence has been constructed (726-3769). I also stated that aII information onthis application/permit is correet and that I vas provided vith the Springfield
Development code requirements for fence standards.
Con t rac t orlIns taIler :
Address:q
re t
FOR OT'FICE USE
Date of Application: I l- I 3.95-JOB *2
Receipt #Issued By:
Total Amount CoIlected:
Clrecked for Delinqueneies: L/-- Checked for Historical Statrrs. <----
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Permit No
Address:Sy'ss /.<zaza
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2
lssued Date: /1'/3 '7 L
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
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:
1. jXl 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 My general contractor is ,
Contractor registration num
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. BJE 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 ! have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
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gnatu rm p ca
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CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
7z 5-?
INFORilI-ATION NOTICE TO PROPERTY OYVNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation Notice to Property Owners About Construction Responsibilities
was developed by-the Construction Contractors Board in accordance with ORS 70{'055(5},
passed ty the 1989 Oregon Legislature.
i,1 - t. ,- l' ',,r, ' . .
Ti you aie hcting as your bwn coritraetor to consttuct a new home or make a substantial imp.r@m'ent to an
existing structurL, you can prevent.many problems by being aware of the following responsibilities and areas
of Cbncern '' .'
EMPLOYER RESPONSIBILITTES
lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting
in the constructio-4 oi l,iprorement ol a resitiential structure, you'will,'1n ntost'iftstahies;'Og..rJed to Oe ai
"employer" and'ti;b p€opie you hirq Witi be "emplgyees'1, As theemployet you.tlJy.qt cgdnply wiin ftre following:
Oregon's Withholdirrg Tax Law: As an employer, you must withhold incorne taxes from ernployee wages at
the time employees are paid You will be Jiable for the tax payments even if -you don't actually withhold the
tax from your employees. For more information, call the Oregon Departrner;t of Flevenue at 378-3390.
Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unerpfoy'rent insurance
purposes on the wages of all employees. For more information, call the Oregon Employrneot8ivision DHR
at 378-3224.
Workers' Compensation lnsurance. As an employer, you are subiect to the Oregon Woikers' Compensation
Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers'
compensation insurance, you may be subject to penalties and will be,liaible for a{l claim costs if one of your
employees is injured on the job. For more information, callthe Workers' Compensation Division DIF at 373-7434,
U.S. lnter.!'ral Revenug Service: As an employer, you must withhold federal income tax from employees'wages.
You will be liable for the tdx paymenf even if you didn'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 requirements that may be brought to your attention through inspections.
Liabil and lnsurance: Contac't your insurance agent to see if you have adequate insurance
coverage for accidents an omtsst ons 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.
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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 10124189