HomeMy WebLinkAboutPermit Fence 1992-08-05225 North Fifth Street
Springfield, Oregon 97477
FENCE PERHIT APPLICATION
CITY OF SPRINGFIBLD
BUILDING SAFETY DIVISION
SPrlIiIGFIELD
0ffice:
INSPECTION LINE:
7 26-37 59
726-37 69
C'TY OF SPB"VGFIELD,OREGO'V
JobLocation: lZd- N ZtSl V
Assessors Map *:o
0vner:
q
Ltt/ra-n
State:a€*
74a - 171 Iv3
Tax Lot *:
Phone #:Address:
Ci ty:t Zip:lutt
value of Fence , 4 fin-',. 5b Fence Permit is $5.00
Con t rac torl Ins t aI ler :
Address:Phone *:
Ci ty:State:zip:
Construction Contractors Registration #: Expires:
? -s--72
S g Date
FOR OFFICE USE
Date of Application:7 -q4 JOB *:Qzr "7D
Recei p t lt Issued By:
Total Amount Collected: 5-dD
Clrecked for Delinquenc'ies: "/ Checked for Historieal. Statrrs, l/
By signing this permit/application, I agree to call for an inspeetion onee 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 Springfietd
Development code requirements for fence standards.
Permit No:
*
1
2
Address:
lssued Date:3
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 numbe
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
3.B I will be my own general contractor.
lf t 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 inlormation is correct and that I have read and understand
the lnformation Notice to Properly Owners about Construction Responsibilities on the
side of this
8-r-7L
re of Permit Appl cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J Bt91
3
OR
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
.+
d#
INFORT,,ATION NOTICE TO PROPERTy Or,,ilERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: fhis lnformation Notice to Property Owners About Construction Responsibilities
was develon.eO Oy1!e Construction Contractors Board in accordance with ORS 701O5S(O,passed by the 1989 Oregon Legislature.
!
lf you are acting as your own contractor to construct a new home or make a substantial improraement to an
existing structure, you can prevent many problems by being aware of the following responsibilities and areasof concern
EMPLOYER RESPONSIBILITIES:
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:
9reqon's Witlnou As an employer, you must withhold income taxes from employee wages at
the time employees are paid. You will be liable for the tax payments even if you don't actuallywithhold the
tax from your employees. For more information, call the Oregon Department of Revenue ai gZA-SggO.
Unemp loyment lnsurance Tax: As an em ployer, you are required to pay a tax for unemployment insurance
purposes on the wages o{ all employees. For more information, callthe Oregon Employment Division DHB
al378-3224-
Vorkers'Com nsation lnsurance: As an employer, you are subject to the Oregon Workers'Compensation
Law,must obtain workers' compensation insurance for your employees. lf you fail to obtain workers'
cornpensation 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 g7g-74u.
U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages.
ymentevenifyoLdidn,tactuallywithholdthetax.Formoreinfoimation,call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
-iqe ternpllnee: As the permit holder for this project, you are responsible for resolving any failure to meet,.ode requirements 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 Su seE 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. ,- .t
lf you have additional questions, write to: Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10t24t89