HomeMy WebLinkAboutPermit Fence 1995-09-14FENCE PERI{IT APPLICATION
CITY OE SPRINGFIELD
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0ffice:
INSPECTION LINE:
225 North Fifth Street
Springfield, 0regon 97471
726-3759
726-3769
Job Location: 39,q1 v\ rz4-,-N i A Srggg-
Assessors Hap fi, l-7 OZ- 3t L+Z+rax Lot *: OZI 6{
Owner:Ltlr +
Address:Phone #:_.tl ,-
Cl ty:id State:r zip , ?tqfl
Value of Fence:?DO.DD Fence Permit ls $5.00
Con trac tor/Ins taller:
Address:733t vi r/r-ltA b/ phone*:
Cl ty:State:o{L zip:
Construction Contractors Reglstration fi :lres:
By slgnlng thls permit/appllcatlon, I agree to caII for an inspectlon once my
fence has been constructed (726-3769). I also stated that aII lnformatlon onthis applicatlon/permit is correct and that I rras provlded vitlr the Sprlngfteld
velopment code requlrements for fence standards.
S ture Da
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FOR OFFICE USE
Date of Appllcation:q- q-q1 JOB *:5tq
Recerpt o O\(BEl r""uua [, |-J a-yr- L.AA
TotaI Amount Collected:U
Checked for Delinquencies:
6D
Checked for Historical Status:
Statement: Information 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 statementbefore abuildingpermit canbe 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.
fiU in.!,!e appropriate blanks and initial boxes I and2, and either box 3A or 3B:
1. I own, reside in, or will reside in the completed structure1'/
Permit #:
q li rx,,AAddress:
Issued by , N/ -ttn Dare: 9 - t3-q5
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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.
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 notiff the office issuing this building permit of the
name of the contractor.
I hereby certify thatthe above information is correct and that I have read and dounderstand the Information
about Construction Responsibilities on the reverse side of this
OR
Notice to Proryrty Owners
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(Signature of permit applicant)
(White copy to issuing agency permit file,
pink copy to applicant)
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Information Notice to Property Owners
. About Gonstruction Responsibilities
N*te: This Information Nati{e to Propbrty Awners abaut Construction Responsibtlities
was devel*ped by the Construction Contr*ctors Board in arcardance with ORS 701.055(5).
If yau are acting as )'*ur *rv* c*ntra*t#r to construct a fiew hamr: or rnake * substantiirl impr*vement to an existing structure,
yclu ca"n prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYEH RESPON$IBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constmcting or assisting in the
construction or improvement 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 rnust withhold income taxes from employee wages at the time employees
are paid. You will be liable for the tax payments eyen if you don't actually withhold the tax from your employees. For more
informarion, call the Oregon Dept. of Revenue at 945-8091
Unemployment insurance tax; As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. F*r rnore information, call the Oregon Employment Division at the Department of Human Resources
at 378-3524.
Workers'compensation insurance: As an employer, you are sutrject to the Oregon'W*rkers' Compensation Law, and must
obtain worker# compensation insurance for your employees. If you fail to obtain workers' compensation insurance,youfftl&j
besubjecttopenaltiesandwillbeliableforallclaimcostsifaneafyouremployeesisinjuredonthejob. Formoreinformation,
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 frcm employees' wages. You will be
liable forthe tax payment even if you didn't actually withhold the tax. For more information, call the Intemal Revenue Service
ar l-800-829-1040.
OTHEH HESPONSIBILITIES AND AHEAS OF CONCEHN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requiremgnts
that may be brought to your attention through inspections. ,
Liahility and property damage iftsurance: Contact your insurance agent to see if vcu have adequate insurance coverage for
accidents and omissians such as falling toals, paint overspray, water damage from pipe punctures, fire, or work that must be
re-done.
Time tc supervise ernployees: Make sure ycu hav* sufficient time to supervise your empl*yees.
Expertise: Make sure you have the expertise to act as your own general ccntractor, to co*rdinate the work of rough-in and finish
trades, and to notify building nfficials at the appropriate times so they can perform th* required inspections"
If you have ailditianal questions, write or call the C*nstruction Contractars Board {PO Box 14 i40, Salern, OR 97309-5052,
50313?8-4521)" The Board is tr*cated at ?00 Summer Sr. FtrE Suite 3tH, in Salem.
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