HomeMy WebLinkAboutPermit Fence 1992-10-09225 North Fiftli Street
Springfiel<l, Oregon 97477
FENCII PERil-{? r\PPLICATION
CITY O}.' I;PRING}"I]iI,T)
BUTLDIIVG SA.}'JITY I}I\IISION
SPllINGFIELC,
0f f i.ce:
IIISPECTIOI{ LTNE:
7 26-3t 59
726-37 69
-CITY OF OREGO'V
Job Location:
Assessors }la p lt:
0vner:
Address:
Ci ty
Value of Fence:
Con t rac t orlIns t aI}er :
Addres-s:
Tax Lot ft
Phone #:
State:zip:
o.J !'ence Permi t is $5.00
Ci. ty:__Sta,te:zip:
Construction Contractors Registration {}: Expires:
p-?-?e
gnature Date
I',r,tn ,-,atraE usB
Date of Application:{t:
Receipt #-Issued Bir
TotaI Amount Col]ected:
b
Checked for Delinqueneies:Checlred for Hi,storieal Statrrs:
DI
Phone *:
By signirrg tlris permtt/application,.r agree to c:.r.ll for an i"nspeetion onee myfence has been cclnstnrcted (72.rt-37(t9). I also stated that aL1 information onthis application/permi t is coi:rect and thar. r vas providerl vi th the Springf ieJ.rlDevelopment code requ j.rernents f or f ence stantiard.s.
IPermit No:
Address:
lssued Da
R OFFICE USE ON
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
underORS 701.010(7), need not submit this statement. This statement will be
filed with the permit.
Fill in the plicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
1
2
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.
OR
3.A My general contractor is ,
Contractor registration numb
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 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 this form.
lo-q-9a
gna ture rmit Appl cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFORTy|ATION NOTICE TO pROpERTy OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
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 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 strueture, you will, in mbst 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.
Unemployment lnsurance Tax: As an em ployer, you are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment Division DHB
at 378-3224.
Asanemployer,youaresubjecttotheoregonWorkers'Compensation
Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers'
compen$ation 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 gft74*.
U.S. lnternal Revenue Service: As an emp loyer, you must withhold federal income tax from employees'wages.
Youw@ymentevenifyotididn,tactuallywithholdthetax.furmoreinformation,call
the lnternal Flevenue Service at 221-3960.
t
OTHER RESPONSTBILITIES AND AREAS OF CONCERN:
-ode Compliance: 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 Supervise Employees: [tIake 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 9/310-0151
Phone 503-3784621
NOTE: This'lnformation Notice to Property Owners About Construction Responsibilities
was developeci ny the construction contractors Board in accordance with oRS 701.055(5),
passed by the 1989 Oregon Legislature.
4244J 10124t89