HomeMy WebLinkAboutPermit Fence 1992-05-19CITY OF SPR"VGFIELD, OREGO'V
FENCE PERHTT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPFIItlGF!ELO
0ffi ce :
INSPECTION LINE:
726-3759
7 26-31 69
Job Location:
Assessors Map #:I oa },utt Tax Lot *:lLl SoctI
0vner:
Addresst 2325 C</Phone *:J4Z:3 2} Z
Ci ty:State | /) /?zip:
varueof Fence, frlOOoo Fence Permit is $5.00
Contractor/Ins taIler :
Address:Phone *:
Ci ty:State:Zipz
constructionContractorsRegistrationl*:-Expires:
By signing this permit/application, I agree to caII 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 vas provided vith the Springfield
Development code requirements for fence standards.
€ #ho J1..u.o.-n s- [1 -??
Signature Da te
FOR OFFICE USE
Oun -a.,r
Date of Application:5 JOB *: q2O1Ll I
Receipt + ql Aq
Total Amount Collected, !.OO
Issued By:
Clrecked for Delinqueneies: k Checked for Historieal. Statusr_Y
--
225 North Fifth Street
Springfield, 0regon 97477
r' ,/ /), .)
Permit No
Address:
of lo)11 I
-lLrs N, a70aQ-
1
2
lssued by ah Date: 3f ,a 19)
R OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS701.055(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.
A Mv oeneral 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.
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 information is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reYerse side of this form.
*./,,-*jru -Bun^arzl Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
3
OR
r+<r
.-X'
INFOR,.,ATION lrlO'flCE TO PF OPERTY Or. r.lERS
ABOUT CONS:] RUCTION RESPONSIBILITIES
NOTE: This lnformation Notic > t r f)roperty Ownt rs About Construction Responsibilities
was developed by the Constructio"r )ontractors Boa d in accordance with ORS 701.055(5),
passed by the 1989 Oregon Legrs ature.
lf yori are acting as your own contractor to c( nsitruct a new lrome or make a substantial improvement to an
existirrg structure, you can prevent many proll erns by being .ware of the following responsibilities and areas
of co'ic€,rn
EMPI.,O\'ER RESPONSIBILITIES:
lf you rir: persons not registered with the Corrr,l 'u:tion Contrac ors Board to do labor in constructing or assisting
in the ccnstruction or improvement of a resiij lntial slructure, you will, in most instances, be ruled to be an
"emp oy,:r" and the people you hire will be "3^,tp'sr"*s". As th e employer, you must comply with the following:
Ort:go n's Withholdi Tax Law: As an emprl,ly,3p you must rrithhold income taxes from employee wages at
the tinre emp oyees are paid. You will be i;l rle for the tax p ayments even if you don't actually withhold the
tax fram your employees. For more inforrrri ti<:n, call the C regon Department of Revenue at 378-3390.
lJn,,rmployment lnsurance Tax: As an BrTl[ilrl /er, you are req;ired to pay a tax for unemployment insurance
puri.)os;es on the wages of all employees. :r)" rfiore informat on, call the Oregon Employment Division DHR
at i\78-3224.
Wo <ers_Compgryglgn"]Me!qg. As an err rployer, you ar€ subject to the Oregon Workers' Compensation
Lau' ard must obtain workers'compensa:i,:r nsurance for your employees. lf you fail to obtain workers'
con pensation insurance, you may be subj.:r: tr: penalties ar d will be liable for all claim costs if one of your
em;:loyees is injured on the job. For more in:c,r niltion, call the 'Vorkers' Compensation Division DIF at 373-74U.
U.S Internai Revenue Service: As an emplcye r, '/ou must with rold federal income tax from employees' wages.
%u ,viii ne tiaUte tor tnEGx payment even if ror didn't actua lly withhold the tax. For more information, call
the lnternal Revenue Service at 221-3960.
OTHEI::I FIESPONSIBILITIES AND AREAS C,I,' CONCERN:
Coci*,1 Compliance: As the permit holder for 1.i is project, you . re responsible for resolving any failure to meet
cod*,r requirements that may be brought to y lur attention th'ough inspections.
Liability and Property Damage lnsurance: Ccn lar:t your insurar rce agent to see if you have adequate insurance
cov€,'ag€ for accidents and omissions such a; {alling tools, p aint overspray, water damage from pipe punc-
turer,;, fire, or work that must be re-done.
Timt: to Supervise Employees: Make sure / ru have sufficie nt time to supervise your employees.
Expr;rti:;e: Make sure you have the experti ;e to act as your (,wn general contractor, to coordinate the work
of ro.rglr-in and finish trades, and to notify brrikling officials et the appropriate times so they can perform
the r r;quirecl inspections.
lf you lave additional questions, write to:Constru :tion Contractors Board
700 Surrmer St. NE, Suite 300
Salem, fR 97310-0151
Phone 503-378-4621
0244J 10tit4tg9
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