HomeMy WebLinkAboutPermit Fence 1993-07-30225 North Fifth Street
Springfield, 0regon 97477
FENCE PER}IIT APPLTCATTON
CITY OP SPRTNGFTELD
BUILDING SAFETY DIVISION
SPRI'{GFIELD
0ffice:
INSPECTION LINE:
726-3759
7 26-37 69
OREGO'UCITY OF
Job Location:
Assessors Map *:Z
Ovner:
Address:
7Y'-
o Tax Lot *: O2'-,Dr)
Phone *,7 Zlo-?bJL
Ci ty:State:zip:Qaq 17
Value of Fence:1rc-ce Fence Permit is $5.00
Cont ractor/Ins taller :
Address:Phone *:
Ci ty r State:
Construction Contractors Registration *:
Zip:
Expi 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 with the Springfield
Dgvelopment code requi ts for fence standards.
0P-
t re
FOR OFFICE USE
Date of App
Receipt #
Iication:JOB *:
Issued By:
Total Amount Collected ' e'o-D
Checked f or Delinquenei es: t----'Checked for Historical Status ' l-"--
Permit No:
Address:
lssued Date:
OR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILIT!ES
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 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 certily 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.
5r,-
1
2
3
OR
n ure cant
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE @PY TO ISSUING AGENCY PERMTT FILE
PINK COPY TO APPLICANT
NOTE: . This lnformation Ndice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701055(5),
passed by the 1989 Oregon Legislature.
lnroniarpN NoncE To pRopERTv oimens
ABOUT CONSTRUCTION RESPONSIBILITIES
lf you are acting as your own contractor to construct a new home or make a substantial improvement
existing structure, you can.prevent many problems by being aware of the following responsibilities and
of concern
EMPLOYER RESPONSIBILTTIES:
to an
areas
lf you hire persons not registered with the Construction Contractgqs Board to do labor in constructing or assisting
in the construction or improvement of a residential structure, you'will, in most instances, b'd ruled to be an
"employer" and the peopie you hire willpe "employees". As the emplgyer, you must comply with the following:
i_i .: ,:,
Oregon's Wtthhol{!1gl3l Law: As an emplciyer, you must.withhold income taxes from employee wages at
the time employees are. paid, You will be liable for the tax paypents evqn if you don't actually withhold the
tax from your employees. For more information, call the Oregon Dep?rtmg.A{ of Revenue at 378-339O.
Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, eall the Oregon Employment Diyision DHR
at 378-3224.
. t J, j'ii
Workers' Compensation lnsurance: As an employer, you are subject:tolhe Oregon l/\brkers' Compensation
Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers'
compensation insurance, you rnay be subject to penalties and wlll be liable for all ctaim costs if one of your
employees is injured on the.iob. For more information, calllh?W._grkers' Compensatlgl Division DIF at gf3-7434.
U.S. lnternal Revenue Service: As.an employer, you must withhold federal i1"_cgme tax from employees' wages.
ymenievenifygu.didn,tactualljl.yvithholdthetax.Fcir.moreinformation,call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCEBN: ,.
Code Compliance: As the'permit holder for this proiect, you are responsible for,resolving any failure to meet
code requirement-s,that may be brought to your attention through inspections.
Liability and Propeity Dantdge lnsurance: Contact y6ur insurance agent to see if you have adequate insurance
coverage for acciderrts and omissions such as falling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re-done,
,...'. ,.,.. r., .fr ;;f; ,;i , : .: r':. r.jti
Time to SuperviSdfmployees: Make sure you.hane sufficienttime to,supervise your enrployees.
',.';.' : l
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 97310-0151
Phone 503-378-4621
o244J 10t24t89