HomeMy WebLinkAboutPermit Fence 1995-09-06grr 0F onEGorv
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rENCB PBRHIT APPLICATION
CITY OP. SPRINGTIELD
BUII.DING ShTMY DIVISION
225 North Fifth Street
Springfield, 0regon 97477
Job Location:
Assessors HaP *:3t L
0ffice:
INSPECTION LINB:
ax Lot *:36D
726-3759
726-3769
tL
LaOwner:tt'llr A ,t)TT
L Phone *:7 47- 5 33:
zip:
Address:
ct
Value of Fence:
State:
a:)Rrl Fence Permit is $5.00
Con trac tor/Ins taller::T et F
Add ress: ? tz-s 38+k )i--
Cl ty:s S tate :
Constructlon Contractors Registratlon t:
Phone *:
zlp:
Explres:
By signlng this permlt/appllcatlon, I agree-to call for an inspectlon once my
fence has been constructed (726-ii'Ogi, I also stated that all lnformation on
thls application/permlt ls correct "na that I va"-frovtded vith the Sprlngfield
n"""friri","nt code iequirements for fence standards
gna ure
FOR OFFICE USE
Date of APPIication:
Receipt *OtX 4 zC
Total Amount CoIIected:
JOB T:llq*
*
Issued BY:
9.
Clrecked for Delinqueneies:
5
5
Checked for Historical Status:
q '74
1-q7,(
Permit #:
Issued bY:
)(--/Address
/{Date:q --(p 4i
-/L ST
Fill in the appropriate blanks and initial boxes I and2,and either box 3A or 38:
X 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 rs
(Name)Contractor regis' #
the structure must be
I will instruct mY general contractor that all subcontractors who work on
registered with the Construction Contractors Board.
OR
E 38. I will be my own general contractor
Statemeht: lnformation Notice to Property Owners
About Gonstruction Responsibilities
Note: oregon Law, oRS 701.055(4), requires residential construction permit appli-
cants who are not registered wnn ilre Construction Contractors Board to sign the
fotlowing statementbJTo* obuilding permit canbe issued' This statement is required
for residentiot i,ilaig, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from regisffation under oRS 701'010(7)'
ne e d not submitlhis statement. This statement will b e filed with the p e rmit'
If I hire subcontractors, I w,l hire only subcontractors registered with the construction contractors
Board. If I change my mind and hire ";;;;;"i contractor,r *,r contract with a contractor who is
registered with the d&;;;ri i*"r"olri",;;;il,il oni"" issuing this building permit or the
name of the contractor'
IherebY certifY thatthe aboveinformation is correct and that I have read and do
PropertY Owners about Construction ResPonsibilities on the reYerse
understand the Information
side of this form'
(Signature of Permit applic ano
Notice to
(White copy to issuing agency permit file'
\ "
Pint 'oPY
to aPPlicant)
7 S .?8
)
'c- -
Information Notice to Property Owners
il;ut Construction Responsibilities
..
N<ste: Tltis lnJbrrnatian.No'tice to i'roperly Awners abottt Canstractirsn Responsibilities
'.-*)", ,*r*r*ira u, the clnstruction contractars Board in acxsrdunce w*ith oRs 70J.055(i)'
If y*u are acting as y*Lir {}wn {cntractor t* construct a new home or n:*ke a sut}gtantial inlpr*vernent tCI An exiSting StfUCtUfe,
you can prevent many probiems by being aware of the f'ollowing responsibilities and areas of concern.
EMPLOYEH HESPONSI BILITIE$:
If yr:* hire p*rsons not registerecl with the c*nstructi*n contractars BcanJ t., dc labor in constructing or assisiing in theconstruction or irnprovement of a residential stnicture, yoo *ill, in r-nnst instances, be rured tc; Lre an employer anri th* p*opreyou hire will be empr*yees. As the empr*y*r, y*u must compry with the fufl*wing:
oregon's withholding tax larr: As an ernployer, you must withhold incorne raxes from eripray*e wages at the rim* empr*.v.e*s
lll',ill;,J,::J'l*-.'13:A';1fl::?H?trJ:;Xnif ;*n't u"tou*v withhord rhe rax r;* ),;;pio3,"*. I,*r *ore
unemploym*nt insarrance tax: As an *mployer,-you ar* requireri t* pa)' a tax rb:: *nernproyment insuranc* Fllrpos*s *n thewages of ail ernploy*es' F*r rnore inf'ormailon' catitlr* or*gon Emptoyment Division at the Department *f Fluman Rescurcesat 378-3524.
w'orkers'c*mpensation insurance: As an *rnployer, you are subject to the oreg*n wr:rkers,comp*nsati*n Law, and rnustobtain workers' compensation itisur*nce for your en:ployees. If you fail to obtain*wurkers, ccrnpensatian insurance, ]ic,B maybesubjecttopenaltiesandrvillbeliablefcrallcl;tim"ootrir*n**fy*uremptoy**r;si[ur**onthejob.
Forrn*reinformation,call the workers' cornpensation llivision at the Department ryf consumer and rusin*', services at g45-Tggg.
u's' Internal Revenue service: As an employer, yo* must withhord ferlerar incame tax frorn employees, wages. you w,r beliableforthetaxpaymentev*n ifyoudidn'tactuallywithholdth*tu*. Form*reinformatinn,canthelnternalRevenueserv.iceat 1-800-829-1040"
OTHEH RESPONSIBILITIES ANN AHEAS OF CONCERN:
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Liability and property damage insurance: contact y*ur insurance agent to see if you have adequate insurance coverage f,oraccidents and omissions such as fatling tools, paint -;*;p;;;,;;rer damage from pipe punctures, fire, or work that musr bere-done.
Time to supervise ernployees: Make sure you have sufficient time to supervise y*ur empl*yees.
Expertise: Make sure you- have the expertise to act as your own generar contractor, to cnordinate the work ofrough-in and finishtrades' and to notify building or*ciats ai trre appropriate times Io they can g"rr**o ,1, *quired inspections.
ll,iff ?ffiff,ffiHx*lil;I,Jl-.11;t!ffi::rrffi":#Tffi':,T ff:f ,"* Box r4r40, sarem, oR e?30e.s052,
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