HomeMy WebLinkAboutPermit Fence 1994-03-22FENCE PERHIT APPLICATION
CITY OF SPRINGPIBLD
BUII,DING SAFETY DIVISTON
SPR!NGFIELD
726-37s9
726-3769
Al 2a-fr,- q lv -o o^*Job Location:
Assessors Map #, \1 l")Tax Lot lt: \= OaC
OREGO'VCITY OF SPR
0vner: 6
Address:
Ci ty:
Value of Fence: 'i
1
&lxs
Phone #:7 r{a =.{,/ j
State:zip:?)(T1
Fence Permit is 95.00
Con t rac tor/Ins taIIer :
Address:Phone *:
Ci ty:State:Zipz
Construction Contractors Registration #:Exoi res :
By signing this permit/apprication, r agree to calr for an inspection once myfence has been constructea (zzo-s76g). r also stated that at1 information onthis application/permit is correct and that r vas provided vith the springfieldDevelopment code requirements for fence standards.
(
\S ure Dat e
FOR OFFTCE USE
Date of Application: )-Z YUJOB *:
Receipt #Issued By:
Total Amount Co1lected:
Clrecked for Delinquenei es: .?-,.Checked for Historieal, Status. L-'-'
225 North Fifth StreerSpringfield, 0regon 97477
0ffice:
INSPECTION IINE:
dk
(
L
lssued Date:
OR 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 t applicable blanks, and initial boxes 1 and 2, and either box 3A or 38
Permit No:
Address:7 tl LD*'.3-
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 eompletion.
1
2
OR
3.A
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.
3.8 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.
! hereby certify that the above information is correct and that I have read and understandthe lnlormation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
1#t
CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPUCANT
Vtzz
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 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 improvement to an
existing structure, you can prevent mqny problems by being aware of the following responsibilities and areas
of concern.
EMPLOYER RESPONSI BILITIES:
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
uwillbelia'.bleforthetaxpaymentsevenifyoudon,tactua|lywithholdthe
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
mployees.Formoreinformation,calltheoregon.ErnploymentDivisionDHR
at 378-3224.
Workers'Com nsation lnsurance: As an employer, you are subject to the Oregon Workers'Compensation
Law, and must n 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, callthe Workers' Compensation Division DIF at 973-74U'
U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages.
ymentevenifyoudidn'tactuallywithholdthetax'Formoreinformation,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
coA-e requl?ements 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 falling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re-done.
Time to Supervi se 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 rougLl-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
o244J 10124189