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Home My WebLink AboutPermit Fence 1996-04-05225 North Fifth Street Springfield, Oregon 97477 FBNCB PBRHIT APPLICATION CITY OP SPRINGFIELD BUII.DING SAFETI DIVISION SPR!TTIGFIELD 0fflce: INSPECTION LINE: 726-37s9 726-3769 CITY OF OREGO'V Job Location: 82t A/t84-1,- Ss Assessors Hap * , j] 93 3lq Zl r""tot *: /5 Ovner:t Address: Ci ty:*lrt r.QA,t p 0 0 State: O Pot & S ture FOR OFFICE USE Phone *: I Zip:q-7+-17 +-s -qQ, Date ooValue of Fence:t-Fence Permit is $5.00 Con t ractor/Ins taller: Address, *Ll n. I Phone *: a1 I -377 Ci ty:State:OL Zi p:9t 41t construction contractors Registration *. ,- Exp ires: - By signing this permit/application, I agree to caII for an inspectlon once my fence has been constructed (726-3769). I also stated that aII information on this application/permit is correct and that I vas provided vith the Springfield Development code requirements for fence standards. Date of App Iication, z7-5- 1O JOB *:1ao+7s Receipt *q8 rssued By: n fn A<-h p Dq Total Amount Collected:5a) Checked for Delinquenei .", -,/Checked for Historical Status, / *el^ 1+t -311 - C. /AA *ft<)ae Permit #: Address:Kz n t8+t- sr Issueduy,@ou,", Statemert: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon l,aw, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the fotlowing statement before a building permit can be issued. This statement is required for residentiat 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 appropriate blanks and initial boxes I and2, and either box 3A or 3B 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. OR 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 that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. "/ ilr^*ru,7 ^ 4-s -o( @applicant) (White copy to issuing agency peftnit file, pink copy to applicant) ---r--- (Date) x X' B to Property Owners , 'About $onptructi on Hesponsibilities ' 1Yt',.' t it,', iti.lt,rrnqtiut.t tlt)tice to f1'ttpcrt;' On,twrs ubottt Consrrrtr.tion Rt,.,:pttrrsiltilitiei.\-'| \-{' v'tti i|,,, i - ht'lh* Cortst'rurlion Coutiactors B,,t;rtl in at.rortlun, t ,ti:it ilns lnt.OSS(1): |ou u:iil-l prcY0tllin.lrry !,ioi',rurs by. leilg aware of tiri lollowrng responsibiliue; and areu-' iif conccm. ;. EM PLOYER HESPONSIBI LITIES: If you hire persons nci registcred *it the Construction Contractors Board.to do labor in construcring or assisting in the conctntction or i.mprovernent of a residential structure, you will, in most instances, Ue ruii:O to be an "*pioy", and the people you hire will be employees. As the employer, you must comply with the following: : : ' Oregon'swithhdldingtaxluw: Asanemployer,'youmustwithholdincometaxesfromemployeewagesatthetirneemployees are paid. YoLr will be liahle ttrr the tax payments eten if you don't actually withhold the tax frorn your'ernployees. For more information, call the Oregon [)ept. of Revenue'at945-8091 ,. . ,i Unemploymerrt insurance [ax: As an ernployer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. Fcr rnure informalim, cdl the Oregon EmploymentDivisiOn at theDepar-tmeisp{;!rg,rlfpResguggep at378-3524 Workers'contpensation insurance: As an employer, you are subject to the Oregon Workers'iornf.nrrti[n Lu*, urd]# obtain workcrs' !^ornperr:.atiurr ir,surance for your entployees. If you tail to obtain workers' compensation insurance, yokmay beiubjecttcfpenaltiesrndu,iilbeliibteibriilclaimcostiifoneofyouranployeesisinjuredonthejob. Forinoreinform&4 call the Workers' Comp*nsrlion l)ivision at the Department of Consumer anci Busines.s:Services *i945-?88b'. US.Internal Revenue Ser.,'ice: As an employer, you must withhold federal income'tax fror?i8fnp$cr'wtr$Es. :fou wi[ Ud liablefor+hetaxpaymeirtcvrn ifyoudidn'tactuallywithholdthetax. Fkrrmoreinformation,callthelnternalRevenueSeivlce OTHER RESPONSIBILITIES AND AREAS,OT COruCERN; Code compliancel As the pern:it holder l'or this project, you are responsible for resolving any failure to meet code that may be brought to your attention through inspections. i , ' , , , Liability 3nd propurty tlan-ltigc insurance: Contact your insurancc agent to see if yr,ru have adequate insurance coverage for accidents and on':issious sue h .u falling tootrs, paint overspray, water damage from pipe pLrnctures, fire, or work that mr"rst be re-done. Time to supervise empl*y*es: N{ake surc you have sufficient time to snpervisc your employees. t*pertise: Make sure you have the expertise to act as your own general contractdr, to coordindte the work of rough-in and finish trades, and to noofy building officials at the appropriate times so they can perfi*rm the required inspections, ,"{i: - If you have;foiUond queslit-rns, write or call the Construction Contracton$gard.-(F0 Box 14140, Sales\ OX-btrloe-5OSz, 503/378-4621). The Board is located at 700 Surnmer St. NE Suite 300, in Sabm. prop-own.pm4 lt94