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Home My WebLink AboutPermit Fence 1994-04-05225 North Fifth Street Springfield, Oregon 97477 FENCE PBRHIT APPLICATION CITY OF SPRINGFIBLD BUILDING SAFETY DIVISION SPRINGFIELO 0ffice: INSPECTION LINE: 726-3759 726-3769 GITY OF OREGO'V Job Location: Assessors Hap #: /7 O g 72,{ z Tax Lot {t: O 0qP3 owner: AArril i W*rce (L Va+? Address: Cl ty:<0 ra 3 ess 6J *1^o:-I Phone *: 742-7gzo S tate: &zip ,n 7177 Fence Permit is $5.00 u A/, ) lTH 4>Phone *tt7q2-g-r20 t'( Value of Fence:0c ^,o Con trac tor/Ins ta1ler : Addressz 7A3? Ci ty:C L State:PR Zipz 7> tt) z Construction Contractors Registration #: 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 all information onthis appllcatton/permit ls correct and that I vas provlded vlth the Springfield Development code requlrements for fence standards. -q S ture Date FOR OFFICE USE Date of Application: L{ Receipt # TotaI Amount CoLlected: JoB *: aqO 44 L4 Issuerl By:Cg Checked for Delinqueneies: DO Checked for Historical Starus: '-- It-l 1)38 A)ll-*A) tssued uv' DB llsh-,Date: OR OFFICE USE ONLY 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 Permit No Address: STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS" - hBoUf ConsrnucrloN RESPoNStBILITIES Note: Oregon Law, oRS 701.055(4) , req.uires residential construction permit applicants wnJire not registered witn the Construction Contractors Board to ;ig; th" torrowing sta'temeit before the building permit can be issued. This state- ment is requiieO-for residential building, eleclrical, mechanical, and plumbing p.iritr. Liiensed Architect and Enginely gOOlicants, exempt fro.m registration under ORS 70i.Oi0(7i, need not submit this btatement. This statement will be fited with the Permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: 1 2 OR 3. A. tu t pp cant CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 I will instruct my general contractor that all subcontractors who work on the struc- ture must be r6gistered 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. t 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 reverse side of this form. 'tk hc-r Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 6i4 rt OWNERS r lfyouare'actingasyourowncgntractortoconstruct":::1.:,:::Iffi:asubstantialimprovementtoan r existing structurg, you can Rrevgnt ,;; ilbl",; by being aware of the following responsibilities and areas of concern '' i::' ' EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assistingin the construction or improv.gme-lt of a residential structrr",.y9, *lirlr r-* r.i"i;;;,'#i;uted to be an"emplover" and'the people you hire will be ';emptoyees'l ns nil'erpiovi,: vo;;;qffiffiy iiri ,n" folowing: 's With holdi :.. Law: As an erir ployer, you must witnhold income taxes fiom erlp,loyee wages atthe time emp are paid will be liable for the tax payments even if you don't actuallir withhold thetax from your employees. For more information, call the Oregon Depafiment of Revenue at 379-3ggo IErkers'-Compelsation lnsurance: As an'employer,,you are subioct,to the @regon Workers' CompensationLaw,and@ensationinsuranceforyouiemployees.lfyoufailtoobtainworkers, compensation insurance, you may'be subject to penalties and witf be liable for ati claim costs if one of your employees is injured on the job. For mor{fformation, call thgrworkelg,,CgSn"nration Division DIF at3T3-74i4. U.S. lnternal B ue Se S.n employer, you must.wit hhold federal income employees'wages e for if you didn't-aOtually withhold thb tax.re information, callthe lnternal Revenue OTHER RESPONSIBILITIES AND AREAS'OF CONCENU: Code Compliance: As the permit holder for this Unemployment lnsurance iix: As an'employer, you aie required to pay a iax for unemployment insurancepurposes onlFe wageaoEEamployees, For more information, call the &egon.Emptoyment Division DHRat 378-3224. tax from-.. I For mo code requirements that may be brought to you Liability and Property Damage lrsuranbe: Contact your insufrance agent'to see'if you hhve adequate insurance coverage for accidents and omissions such as falling tools, paint oversprayl'Wlter damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sur6: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 therequiredinspections. ,.. , , , ..: lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 9/310-0151 Phone 503-S/8-4621 was developed by the Construction Contractors passed by the 1989 Oregon Legislature' About ConStrudion in accordance withlntormationOwnerstoPropertYNoticeThisNOTE Board Responsibilities oRS?$.0$6\, 4244J 10t24t89