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HomeMy WebLinkAboutPermit Fence 1992-03-27CITY OF OREGON SPfI'^,GF'ELE' FENCE PERHIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFBTY DIVISION fie e State:0{- Fence Permit is 55'00 FOR OFFICE USE oZE)dO Tax Lot *:()7 AOI Phone *: Zip:4t +78Addr<iss: Ci tY: Valtre of Fence:tffi-dD Con t rac t or / Ins taIler : cil.[A^^ S gnatu 0ffice: INSPECTION LINE: 7 26-37 59 726-37 69225 North Fifth Street Springfield, Oregon 97417 Job Location: €tLc <_ o't'" ,1 0z- a Assessors MaP *: Ovner: Address: State: Phone il: Zip: :^ zr -9 ? Da te Construction Contractors Registration *:Expi res : By signing this permit/application, I agree to call for an inspection once my fence has been constructed (726-ilOg>. I also stated that all information on this application/permit is correct and that I vas provided vith the Springfield p"r"f"bir"nt eode requirements for fence standards' Date of Application t 7'27 *??JOB #:2D4 7 Receipt #4te fssued By: Total Amount Collected , f,-->.CTZ> Checked f or Delinquene i e.s:Checked for Historieal Status: ./ 1 7\ Permit No: Address: lssued by Date: 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 number 1 2 3 OR 3.8 I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. I will be my own general contractor. lf I h1re subcontractors, I will hire only subcontractors registeied with the Construc- tion Contractors Board. lf .l change my mind and do hire a general contractor, I will contract with a contractor who is iegistered 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 intormation is correct and that I have read and understand itre tnt6rration Notice to Property Owners about Construction Responsibilities on the reverse side ol this form. 't--,'{3 x Dateignareof Perm ppt CONSTRUCTION CONTRACTORS BOARD 0244J 819',1 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with OFIS 701.055(5), 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, yCIu 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 ol 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: n's Withholdi Tax Law: As an employer, you must withhold income taxes from em ployee wages at the eem oyees 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 em ployer, you are required to pay a tax for unemployment insurance purposes on t at 378-3224. wages 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 obtarn workers-compensation insurance for your employees. it 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, callthe Workers' Compensation Division DIF at g7g-1494. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. ymentevenifyoudidn,tactuallywithholdthetax'Formoreinfoimation,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. Liabil and lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and tures, fire, or work that mu omrsstons st be re-do such as falling tools, paint overspray, water damage from pipe punc- ne. Time to Supervise E mployees Irtlake sure you have sufficient time to supervise your employees. E.xpertise: Make sure you have the expertise to act as your own general contractor, to coordinate the workof 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 S00 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10t24t89