HomeMy WebLinkAboutPermit Fence 1995-06-23CITY OF SPRlrilGFIELD
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TNSPECTION LTNE:
225 North Fifth StreerSpringfield, Oregon 97417
Job Location: 3O3 No -3
Assessors M"p #,OL '-75
0vrner: L
Address:
Ci ty:
Value of Fence:#
Con trac tor/fns taller:
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Address:
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PENCB PERI{IT APPLICATTON
CTTY OF SPRTNGFIELD
BUTI.DING SAFETY DTVTSTON
726-3759
7 26-37 69
Construction Contractors Registration #:
Tax Lot *r C3
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Fence Permit is g5.OO
Phone #: 1 zlL-q sq9
State:\r zip:7Ll 77
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FOR OFFICE USE
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By signing this permit/appricatiglr r agree to carr for an inspection once myfence has been constructed (726-3log). -r also stated that arr information onthis application/permit is correct and that r was provided with the springfierdDevelopment code requirements for fence standards.
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Date of Appricati onr() - Z3-7 ,-
Receipt *
Total Amount CoIIected:
JOB *:
Issued By:
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Checked for Delinquene.ies :
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Checked for Historica 1 Status z L--
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<i=Permit #:
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Issued A--/4
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Statement: lnformation Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who 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 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 appropriate blanks and initial boxes I andZ, and either box 3A or 38:
l. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction conffactor if the structure is sold or offered for sale
before or upon completion.
3,A,. 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 notify the office issuing this building permit of the
name of the contractor.
I hereby certify thatthe above informationis correct and thatl have read and dounderstand the Information
Notice to Property Owners about Construction Responsibilities on the reyerse side of this form.
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(Signature of permit applicant)
(Whrte copy to issuing agency perrnitfile,
pink copy to applicant)
OR
(Date)
nut"W
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Information' Notice to Property Owners
About Construction Respo nsibilities
Note: This Information Notice to P.roperty Own.ers abqut
was rleveloped by the Construi\ion Contractors Boarcl in
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you cran prevent rnarry problems by being aware of thg following rcsponsibilities and areas of concern.
EM PLOYER R ESPONSI BI LITIES:
If you hire persons not registered With the Constnrction Qontractors Board to do labor in gonstructing or assisting in the
construction or improvement of a residential strusture, yqu will, in most instances, be ruled to be an empl-oyer and the people
you hire will be employees. As the employer, you must comply with the following: ,,:
Oregon's withholding tax law: Aii an employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable fbr the tax payments even if you dont actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945-8091
Unemployment insurance 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 Employment Division at the Departutent of Human Resources
at378-3524
Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, *O )"\ll
obtain workers' compensation insurance for your employees. If you fail to obtain workers'compensation insuranpe, 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 mole informati-ory
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. '
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You wlll be
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at l-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible fcrr resolving any failure to meet code requirements
that may be brought to your attention through inspections. .-'q
Liahility 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 overspray, water damage from pipe punctures, 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 ofrough-in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you hive additionhl questions, write or call the Construcilsn Contractort Boar8 (PO Box l4d40i Salem, OR 97309-5052,
5031378-4621). The Board is located at 700 Summer St. NE Suite 3ffi, in Salem.
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C()nstru(tiottResp<tnsibilities :
*t:t:ord*tu:a x'ith ORS 701 .055(5).