HomeMy WebLinkAboutPermit Fence 1994-07-03EE I Icrrv oF sP RINGFI
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FENCE PERUIT APPLTCATTON
CITY OF SPRINGPTELD
BUILDTNG SAFETY DTVISION
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SPRTNGFIELO
0ffice:
INSPECTTON LTNE:
225 North Fifth StreetSpringfield, 0regon 97477
Job Location:
Assessors M"p #,l 1o"1-) L j.[
0vner:
Address:
726-3759
726-3769
Tax Lot #:6 o td(
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Ci ty:
Value of Fence:
Con t rac tor/fns taIler :
Address:
Ci ty:
Xy
S'{-Phone #: -/qu - bq L( {
zip:State:
Fence permit is 95.00
Phone #:
State:ZiptConstruction Contractors Registration #:lres:
signing this permi t/application f agree to call for an in spe ction once
fen ce has been c ons truc ted (726-3769 ). f also stated that al 1i
q
nforma t i on on
thi s applicati onlpermit i s correct and that f vas provi ded wi th the Springf ield
De opmen t code rements for f ence standa rds.
FOR OF FTCE USE
Date of Application:.?
Receipt #L{
my
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#:
?ota] Amount ColLected:fssued By:
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Permit #:
Address:4ofo S 364 Sf
Issued by:(//rr,t*
Statemert: lnformation Notice to Property Owners
About Gonstruction Responsibilities
Note: Oregon l-aw, ORS 701.055(4), requires residential construction permit appli-
cants wh.o are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential butlding, 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 appropriate blanks and initial boxes I and2, and either box 34 or 3B
1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A.. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
38. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notiff the office issuing this huilding permit of the
name of the contractor.
I hereby certify that the above information is correct and thatl have read and do understand the Information
about Responsibilities on the reverse side
of permit
(White copy to issuing agency pennitftle,
pink copy to applicant)
OR
Notice to
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1
form.
D^t", 63-?y'
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Infsrmation Notiee to Property Owners
Ab$ut Ccnstrulct*on ResponslbiIit$es
Nnrr: jrlrrs lnJbrmtsrks* Notit:t to Propertt- Owners abow{ {)rsnstrur:tion &esponsi& ilities ",i .1
wss d*,rl*{ted by the {anstru*ian C{tntractrtr.s Bor*r} in. ar:r:*rrktn.r:e with t}RS 7#1.055(5j.
tr{'yo* art: aeting ;}s your ow{l cofitractt:r tD conslrucN a n*w t-rqrm* or make a substantial impr*vetnent to an rxisting stlurlure,
yi]il can prevent many problems by"being aware ol tho following respr:nsibitrities and areas <if soncern
EM PLOYER RESPONSI BILITIES:
If you hine persons n*t registered witli the Construction Contractors Board to do labor in constlucting or assisting in the
constnicli*n or improvement of a residential structure, you will, in most instances, be ruled to be an ernployer and the people
you hire rvili be empl*yees. As the employer, you must comply wirh the fallowing:
Oregon's withholdixg tax law: As an employer, you must withhold income taxes from employee wage s at the tim* employees
are paid" You wili be liable for the tax payments even if you don't actually withhcld the tax from your emptroyees. F-or more
information, catrl the Oregon Dept. of Revenue at 945-8091.
Unemployment insurance tsx: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all empk:yees. For more information, call.the Oregon Employment Division at the Department of Huma"n Resoufcei
at378-3524"
Workers' compensatiou insurance: As an ernployer, you are subject to the Oregon Workers' Compensation Law, and must
obtain werkers'compsnsation insurance for your employees. If you faii to obtain workers'compensation insurance,.youfiry
be subject to penalties and will be liable for all claim costs if one of your employees is i{ured on the job. For more information;
call the Workers' Compensation Divisicn at the Department of Consumer and Business Services at 945-7888.
U.S. trnternal Rcvenue Service: As an employer, you must withhold federal income turx from employees'wages. You will be
iiableforthetaxpaymenteven ifyoudidn'tactuallywithholdthetax. Formoreinformation,callthelntemalRevenueService
ar 1-800-829-1040.
OTHER HESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you ire responsible for resolving any failure to meet code requiremenls
that may be brought to your attention through inspections.
Li*bility and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools, paint overiipray, water damage from pipe punctures, fire, or work that must be
re-done.
Time tc smpervise employees: Make sure you have suiTicient time to supervisc your employees.
Expertise: Makesureyouhavetheexpertisetoactasyourowngeneralcontractor,tocoordinatetheworkofrough-inandfinish
trades" and to notify buitding officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call t}re Construction Contractors Board (PO Box 14140, Salem, OR 97309-5052,
5Ay378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
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