HomeMy WebLinkAboutPermit Fence 1992-09-18FENCE PERI{IT APPLICATION
CTTY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRIilGFIELO
0ffice:
INSPECTION LINE:
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225 North Fifth Street
Springfield, Oregon 97477
726-3759
7 26-37 69
C'TY OF OREGO'V
Job Location:1Cl- ttJuL (-retl-
Assessors Map * , /7O 7 Tax Lot #: l2 I c2 OL
Ovner:t11
Address:
Ci ty:
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vartre of Fence , E3* o
Phone #, 1L/U),)g Q(t1
zip:Q l4 r-l
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Fence Permit is $5.00
Date
Con t rac
Address
Ci ty:
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Construction Contractors Regis ation #: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 all information onthis application/permit is correct and that I vas provided with the Springfieid
Development code req uirements for fence standards.
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tor/Ins taI r:
c
ure
FOR OFFICE USE
Date of Application:
Receipt lt
Total Amount CoIIected <9O
JOB *:?zt 3azao2_
Issued By:
Checked for Historieal Status:
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Permit No:
Address:
lssued Date:
OR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITTES
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, elec[rical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registratioi
under ORS 701.010(7), need not submit this statement. Thib statement will befiled with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
1 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.
My general contractor is_
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.
2F1
3.A
3.8
OR
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 iegisiered with the Construition Contractors Board
and I will immediately notify the office issuing this building permit of the name ofthe contractor.
l_hereby certily that the above information is correct and that I have read and understandthe lnlormation N.otice to Property Owners about Construction Responsibilities on thereverse side of this form.
na pplican
CONSTRUCTION CONTRACTORS BOARD
0244J 8t9'.1
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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lf you are
existing st
INFOI"gIAIION NOTICE TO PROPERTY ucyNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
acting as your own cohtractor to construct a new home or make a substantial impro{ement to an
ructure, you can prevent many problems by being aware of the following responsibilities and areas
of concern
EMPLOYER RESPONSI BILITIES:
lf you hire persons not registered with the Construction Contractors Board to do labor in constructing 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 must withhold income tqXei from employee wages at
uwillbeiianjeforthetaxpaymentsevenify6u'donltacluaIlywithholdthe
tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390'
Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance
mployees.Formoreinformation,calltheoregonE,mploymgfDivisionDHR
at 378-3224.
'Vorkers' Compensation lnsurance: As an employer, you are subiect to the Oregon Workers' Compensation
r-adTnor"nustffipensationinsuranceforyouremployees.lfyoufailtoobtainworkers,
conrpensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your
empioyees is injured on the job. For more in{ormation, callthe Workers'Compensation Division DIF at 973-7434.
U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees' wages'
YouffiymehtevenifyoudidnTactuallywithholdthetax.Formoreinformation,call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN
.,ode Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet
:IOe requirernents that may be brought to your attention through inspections.
Liability and Property Damage lnsuranee: 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 pipe punc-
tures, fire, or work that must be re-done
Time to Su Employees: Make sure you have sufficient time to supervise your employees.
Expertise: Ivlake sure you have the expertise to act as your own general contractor, to coordinate the work
of rouffin and finish irades, and to notify building officials at the appropriate times $o they can perform
lhe required insPections.
lf you have additional questions, write to Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
paq5ed 'by, t$e 1989 Oregon Legislature.
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