HomeMy WebLinkAboutPermit Fence 1992-02-24FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
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Offi ce:
INSPECTION LINE:
@
225 Fifth Street
Springfield, 0regon 97 477
726-3759
726-3769
Job Location:
Assessors Map #:
0wner:
Address:
City
Phone #:
dD4DC
1l-lo'5b11
7.i ,qState:p
d4rD ,oValue of Fence:Fence Permit is $5.00
Contractor/ I ns tal I er :
Address: Phone #:
City:State:Zi p:
Construction Contractors Registration #:Ex pires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (7?6-3769). I also state that all'information onthis application/permit is correct and that I was provided with the Springfield
Deve'lopment Code requirements for fence standards.
Z-Zf-?a_
na Date
FOR OFFICE USE
Date of Application:obr #:
Receipt #:
Total Amount Co'l'lected:
By:
{3
I s sued&
Checked for Del'inquencies:Y Checked for Historical Status:
lf1\33t 14 Tax Lot #:
(Oo*.:na€l
(
Permit No:
Address:6
Date: &'H'q
1
2
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.
Fiil licable 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 num
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.
I hereby certify that the above inlormation is correct and that ! have read and understand
the lnlormation Notice to Property Owners about Construction Responsibilities on the
reverse side this form.
3-z/-?z
gna m p cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
3
OR
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFOHIIIATION NOTICE TO PROPERTy .,tt/NERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: ' This lnforrrration Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 7O1.OSS(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, you can prevent many problems by being aware of the following responsibilities and areas
of concern.
EMPLOYER RESPONSIBTLITIES:
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
the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the
tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390.
Une ment lnsurance Tax: As an e mployer, you are required to pay a tax for unemployment insurance
purposes on t
a|378-3224.
e wages of all employees. For more information, call the Oregon Employment Division DHR
Workers'Compensation lnsurance: As an employer, you are subject to the Oregon Workers'Compensation
Law, and must obtain workers' 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, call the Workers' Compensation Division DIF at 373-74%.
U.S. lnternal Flevenue 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
code 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 ise Em 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.
lf you have additional questions, write to: Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
o24J 10124t89