HomeMy WebLinkAboutPermit Fence 1992-06-10225 North Fifth Street
Springfield, Oregon 97477
rENCE PERHIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
!iPR!ilGFIELE,
0ffice:
INSPECTION LINE:
7 26-37 59
7 26-37 69
CITY OF SPR OREGO'U
Job Locat i.on:
Assessors Map #:/7o 3
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24 rax Lot #:72 0:O
7 7
Address:
Ci ty:
7%'77 7e Cthaz,
Zi p:State I k
{,2Value of Fence:5Do e'Fence Permit is $5.00
Con t rac tor/Ins t aIler:
Address:Phone *:
Ci ty:State:Zip:
Construction Contractors Registration *: Expires:
By signing this permit/application, f agree to call for an inspection once my
fence has been constructed (126-3769). I also stated that aII information onthis application/permit is correet and that I vas provided vith the Springfield
Development code requirements for fence standards.
b/ t ' ,/r'-ure Date
FOR OFFICE USE
Date of Application:
Receipt + SODA
Total Amount CoIIected:
JOB *: Qz-o z Z3
Issued By:
Cheeked for Delinquencies:
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Checked for Historical. Status , ,/
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Phone #:
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Permit No:?=oszt
Address:
lssued by
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Date 4 2_
1
2
OR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS701.055(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 num
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3 B,!-{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 understand
the lnlormation Notice to Property Owners about Construction Responsibilities on the
side of this form
6 /o 7z-
3
gna ppt t ate
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
CONSTRUCTION CONTRACTORS BOARD
0244J Bt91
=.
tNFoRM;oN NoncE To pHopERTy ow..cnS
ABOUT CONSTRUCTION RESPONSIBILITIES
r
nirolralt'hcting as your bilrri cbntractor to construct a new home or make a substantial
existing structure, you can prevent many problems by being aware of the following respon
irnprovement to an
sibilities and areas
of 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 structur€, you will, in most instances, ti6 ruled to be an
"employer" and the people ytiu hire will be "employees". As the employer, you must comply with the following:
Oregon's Withholding Tax Law: {s an employet you must withhold income taxes from employee wages at
uwillbeliableforthetaxpaymentsevenifyoudon,t,actuaIlywithholdthe
tax from your employees. For more information, call the Oregon Department of ,Flivenue ai gzg-gggO.
Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employm-elt Division DHR
at 378-3224.
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 973-7434.
U.S. lnternal Revenue Service: As an e mployer, you must withhold federal income tax from employees'wages.
You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCEHN:
Code Compliance: As the permit holder for this project, you are responsible for resolving any tailure to meet
code requr rements 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 Supervise 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 rough-in and finish trades, and to notify building officials at the appropriate times so they can perform
lf you have additional questions, write to:Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
NOTE: . - This lnfoirqation Notice to Property Owners About Construction Responsibilities
was developeq by the Construction Contractors Board in accordance with ORS 701.055(5),
pabse{by the 198q Or.ggon Legislature.
0244J 10t24t89