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Home My WebLink AboutPermit Fence 1993-07-02OREGO'VCITY OF SPR 225 North Fifth Street Springfield, Oregon 97477 FBNCE PERUTT APPLICATION CITY OF SPRTNGFIELD BUILDING SAFETY DIVISION SPII!tlfGFIELE, 0ffice: INSPECTION LINE: 7 26-37 59 726-3769 Job Location:+51 l.r 32,,,.t.St Assessors Map #:11 o3>tz.l Aow rax Lot #: 0bZ0O {-0 Ovner: Address L+6q /J 3Ln c ;,/-Phone *: State:lfz-zip:Ci ty: Value of Fence:6llzp da Fence Permit is $5.00 Con t rac tor/Ins talIer : Address:Phone *: Cityr State:zip: Construction Contractors Registration #: E xpi res : By signing this permit/application, I agree to caII for an inspection once my fence has been constructed (726-3769). I also stated that all information on this application/permit is correct and that I vas provided vith the Springfield Development code requirements for fence standards. 7 - z Qs n'\)t'&-la ignature Date FOR OFFICE USE Date of Application:'? "z_.-JOB *:4zo 7b5 Receipt l[(?*,,Issued By: Total Amount Collected:552 Cheeked for Delinqueneies: V Checked for Historical Status, [/' 4-tu -7y Permit No: Address: lssued by ,1 1 2 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. Fiil he 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. 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 information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of form. 7-3 2< ignature m t licant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 \/a^9*-Date n-ry/ (-/ WHITE COPY TO ISSUING AGENCY PERM]T FILE PINK COPY TO APPLTCANT 3 OR rnronJ-rnoN NoncE To pRopERTy owNERs ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Prcperty Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(0, passed by the 1989 Oregon Legislature. ,*i...t', lf you are'actirig as your cilrvn contractor to construct a new home or make a substantial to an existing structure,you can prevent many problems by being aware of the following responsibilities and areas of concern EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Boafd to do labor in constructing or assisting in the construction ol improvement of a residential structure; you will, in most instances, be ruled to be an "employer" and the people you hire wiit,be ''employees".'ls-theemployer, yp.u'n"r,g$ comply Wjtfr the following: .i ,' Oregon's Wlthholding Tax Laryi As an emnlg,yer, you must.w[thhold ipcortre taxgs from employee wages at irwilt.,beliabie"forthetaxpaymgnts'evenifyou'don't..actuallywithhototne tax from your employees. For more information, call the Oregon Depar,tmentof,Revenue at 378-3390. Unemployment I !suranqe IqI As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all emplotees; For more,information, callthe Oregon Employment Division DHR at 378-3224. :l 'ti' Workers' Compensation lnsurance: As anemployeri 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,tor all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. I'i"' U.S. lnterngl Rgypnug Service: A"_an employer, you mus.!wi[hhold federal income tax from employees' wages. ymentevehifyoudidn't'actji4tlywithholdthb'teixFormoreinfoimation,call the lnternal Revenue Service at 221-3960. ] ' OTHER RESPONSIBILITIES AND AREAS OF CONCERN:,,l Code Compliance: As the permit holder for this proiect, yo( code requirements that may be brought-to your attention i !'abilfly 3!qtfqpqrfy Darna$e lnsurance: Contact your insui coverage for accidents and omissions such as falling tools tures, fire, or work that must be re-done. I are responsible for resolving any failure to meet throtrgh inspections. rance agent to see if you have adequate insurance , paint overspray, water damage from pipe punc- Time 'to Supervise Employees Make sure you have s nt time to supervise your "rptoy*"".ufficie Expertise: Make sure you have the expertise to act as your own generalcontractor, 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 inspectiohs. lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 3O0 Salem, OR 97310-0151 Phone 503-5/8.462r o244J 10t24t89