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Home My WebLink AboutPermit Fence 1992-07-06225 North Fifth Street Springfield, 0regon 97477 FBNCI{ PERI'IT APPLICATION CITY OF SPRINGTIBLD BUTLDING SAFETY DIVISION SPFII\lGFIELO 0ffice: INSPECTION LINE: 726-3759 726-3769 CITY OF OREGO'V Job Location:u01 ^J t,t^ * Assessors Map #:t15?14e -- rax Lot *z N;zDl Ovner: Addr6'ss: Ci ty:S tate:0r- Phone *:7 Lb -947 Z'ipl value of Fence , *,*4OO 'OD Fence Permit is $5.00 Contractor/Ins taIler : Address:Phone il: Ci ty: _State: Construction Contractors Registration #: Zipz Expi res : By signing this permit/application, I agree to call for an inspection once my fence ftas been constructed (726-3769). i also stated that aII information on this application/permit is correct and that I vas provided with the Springfield Development code requirements for fence standards. 14 'l-_ S gna e Da te FOR OFFICE USE Date of Application:-b JOB *: Receipt # 6rl,L Issued By:&tl/J't\-A- Total Amount Collected: Checked for Delinqueneies: -- Checked for Historical Stattts2 -- Address: Permit No:lzn1z> sr- WHITE GOPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT lssued 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 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 My general contractor is Contractor registration number-. 1 2 Date:-b I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3 OR 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 lnf6rmation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 7-64L ure o it Appli Date CON STR U CTION CONTRACTORS 0244J 8191 ca t lNFOhrnATlON NOTICE TO PROPERTY O.,,cNEHS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnforrnation Notice to Property Owners About Construction Responsibilities was develcP.ed by the Construction Contractors Board in accordance with ORS 701.0SS(S), passed by the 1989 Oregon Legislature. lf you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, yol"] can prevent many problems by being aware of the following responsibilities and areas of concern EM PLCIYEH RESPOFISI BILITIES: lf you hire perso*s not registered with the Construction Contractors Board to do labor in constructing or assisting in the constructir:n or improvement of a residential structure, you will, in most instances, be ruled to be an"ernployer" and the people you hire will be "employees". As the employer, you must comply with the following: ?reqol's'W$nolW As an ernptoyer, you must withhold income taxes frorn employee wages at the time ernployees are paid. You will be Iiable for the tax payments even if you don't actuallywithhold the tax from your employees. For more information, call the Oregon Department of Flevenue ai gZA-ggg0. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. Foi more infornlaiion, cat ine Oregon Employment Division DHFI at 578-3224. uorkers' ComPelq+qu$ur1ggq As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. it you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable fior all claim costs if one of your employees is injured on the job. For mcre informatlon, call the Workers' Compensation Division DIF at g\g-74g4. U.S' lnternal Hevenue Service: As an emptoyer; you must withhold federal income tax from employees'wages.Y0uffipaymenteuenifyoudidn,tactuallyivithhotdtnetax.Formoreinformation,call the lnternal Revenue Service at 221-3g60. OTHE* HESPONSIBILITIES AND AREAS OF CONCERN: ,ode nce cde requ rements As the permit holder for this project, you are responsible for resolving any failure to meet that may be brought to your attention through inspections. Liability and Property Damage lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as fal ling tools, paint overspray, water damage fr.orn pipe punc- tures, fire, or work that must be re-done Itllglq tgPerylxe Employces: tvlake sure you have sufficient time to supervise your employees, Elpeilqg, Make sure you have the expertise to act as your own general contractor, to coordinate the workof rough-in anQ finish trades, and to notify building officials at th-e appropriate times so they can perform lf you have additional questions, write to Construction Contraciors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 3A0-9Zg-46214244J 10t24t89