HomeMy WebLinkAboutPermit Fence 1992-07-07FBNCE PERUTT APPLICATION
CITY OF SPTI.INGFIBLD
BUII.DING SAFETY DIVISION
SPRIilGT-IELD
Office:
INSPECTION LINE:
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fi'le,$
225 North Fifth StreeL
Springfield, Oregon 97417
7 2.6-37 59
7 26-37 69
a OREGO'VCITY OF
Job Location:{'7 z S urp {ra
Assessors Map *:Tax Lot *:
Ovner:
Ad<lress , 57 2 S> ,:tt+(r#
Ci ty:S>n,rrr4'*L State:___=
Value of Fence:4oc o0
Phone *: '74/- flt-<
Zipz
Fence Permit is $5.00
Contractor/Installer: S. //
Address:Phone *:
Ci ty: State:Zipz
Construction Contractors Registratj.on #:lres:
By signing this pernrit/appl.ication, I agree to caII for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
th
De
1S licati.on/permit is correct and that I vas provided with the Springfield
opmen e requirements for fence standards.
X gna tur e DateS
FOR CFFICE USB
Date of Application:JoB *: 4z)q
Receipt f Issued By:
Tota1 Amount Collected:f)
checked f or Delinquenei es: (-- check'ed f or Historical sta ttts i - r-
"747:
Permit No:7-o1 zb
Address:61 -i-- s qi- t-
lssued 0,,r*-"-Date: 7 -7 -{2.-
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.
A My general contractor is ,
Contractor registration number-
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 certify that the above information is correct and that I have read and understand
3
OR
the
reve
tion Notice to Property Owners about Construction Responsibilities on the
this form.
7-7 - 7z--
nature Appl t
CONSTRUCTION CONTRACTORS BOARD
o244J 8191
ate
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFOh{stATlON NOTICE TO PROPERTY v{t NERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with OFIS 701.055(5),
passed by the 1989 Oregon Legislature.
lf you are acting as your own contractor to construct a new home or make a substantial irnprqiement to an
existing structure, you can prevent many problems by being aware of the following responsibilitfos 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 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 taxes from employee wages at
the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the
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
purposes on the wages of all employees. For more information, callthe Oregon Employment Division DHR
ar 378-3224.
Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' 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 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 323-2494.
U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages.
You will be liable for lhe tax payment 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.
Liability and Propdrti Damage lnsuiance: 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 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 fit24t89