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Home My WebLink AboutPermit Fence 1996-02-12225 North Fifth StreetSpringfield, Oregon 97477 FENCB PERHIT APPLICATION CITI OP SPRINGPIELD BUIIDING SAFETI DIVISION SPl{!,r|GFIELE 0ffice: INSPECTION LINE: 726-37s9 726-3769 .. CITY OF OFEGO'V Job Location, 5Zl Cr - YH Assessors Map #: Y1 OB 35 Zz+rax Lot #: (5-13 Cn: Ovner:\\ Address:\5tt= =S Ci ty ta Phone #: 1*) -=\\G Zi p:t'\.{l-lState:6P.. value of Fence, Sboj +Fence Permit is $5.00 contractor/rnstarrer, =:\\ fA;\fQ-=,=--\\ .--J V..- ] -- Address,5L, n 5Tr*Phone *z -741-F,66Q Ci ty:S tate :zip: 3lt-l-71 Construction Contractors Registration *: -- Expires z - By signing this permit/application, I agree to caII 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 vith the Springfield Development code requirements for fence standards. a- \]-1 b Date of Applicati onZ- |q gnature Receipt * )NG 5a Tota} Amount Collected: Date FOR OFFICE USE JOB *:ol Issued Checked f or Delinquenei e.s: 3. Checked for Historical Status: / Permit #: J,Tt+ fr- Issued by .l')t A'A*,Yt)o Statemeht: lnformation Notice to Property Owners About Gonstruction 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 statement before a building permit can be 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. Fill in the appropriate blanks and initial boxes I andZ, and either box 3,{ or 38 1. I own, reside in, or will reside in the completed structure. 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 notify the office issuing this building permit of the name of the contractor. I hereby certify thatthe above information is correct and thatl have read and dounderstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form.Cls=*-s=J 2- la-?L @applicant) (White copy to issuing agency perrnitfile, pink copy to applicant) OR (Date) Address:5zt n 'a-, '-r' - Information Notice to Property Owners About Construction Responsibilities i Note: This Information Notice to Propefi Qwners about Construction Responsibiliiies " j-- was developed by the Construction Contactors Board in accordance *-ith ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, youcanpreventmanyproblernsbybeingawareofthefol}.owingresponsibilitiesandareasofmncegr. EMPLOYEH HESPONSIBILITIES: If 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 b 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 wit}hold 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 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. For more information, call the Oregon Employment Division at the Department of Human Resources at378-3524 Workers' compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and niust obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, yourrnay besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. 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 from employees'wages. You will be liable forthe tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040. 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 requ-irements that may be brought to your attention through inspections. Liability and property damage insuranoe: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, pairt overspray, water damage from pipe punctures, 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. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140; Sateni, OR 97309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 lt94