HomeMy WebLinkAboutPermit Fence 1992-05-01225 North Fifth Street
Springfield, Oregon 97477
FENCE PERHIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPFINGFIELE'
0ffice:
INSPECTION LINE:
7 26-37 59
7 26-37 69
OREGONCITY OF
Job Location:i?b u 4stu sf-
Assessors Map *:tloZZt Ll L Tax Lot *: Ot 3OC
0vner:
Address:'T^ sJt Phone #:
*7 4l ^q034
Ci ty:d State:0E-zip:q-74ffi
Value of f"n"",C a")Fence Permit is $5.00
Contractor/Ins tal]er :
Address:Phone *:
Zip:
Construction Contractors Registration *: Ex pires:
By signing this permit/applieation, I agree to call for an inspection once my
fence has been constructed (726-3lOg>, I al-so stated that all information on
this application/permit is correct and that I vas provided with the springfield
n"""f"bir"nt code requirements for fence standards'
.s 77
S re Date
JOB *:
FOR OFFICE USB
q Zd6LDate of ApPlication:
Receipt *Issued BY:1i n/Y\q
Tota1 Amottnt Col]ected:
Checked for Delinqtteneies:t /"/ Checked for Historical Status:L//-*'
Permit No:sr
1
2
STATEMENT:
TNFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS7O1.055(4), require-s residential construction permit
applicants wnJire not registered *itn the Construction Contractors Board to
i,gn th" torrowing Jtitemeit before the building permit can be issued- This state-
."nt is requiredfor residential building, eleclrical, mechanical, and plumbing
p"i.it.. Liiensed Architect and Enginell gnOlicants, exempt fro.m registration
under ons zoi.olo(7), need not sudmit this btatement. 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:
Address:
tssued oy: rt'n*Q--
s-- / - qA
Date
WHITE COPY TO ISSUTNG AGENCY PERMIT FILE
PINK COPY TO APPLICANT
Date
OR OFFICE USE ONLY
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 otfered for sale before or upon completion'
My general contractor is
Contractor registration num
3.A
3.8
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be r6gistered with the Construction Contractors Board'
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 iegis[ered with the Construction Contractors Board
and I will immediately notify the ofJice issuing this building permit of the name of
the contractor.
I hereby certify that the above information is correct and that I have read and understand
the lnformation uotice to property On ners about Construction Responsibilities on the
reverse side of this form.
L
ure mit App cant
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
ls 6 ^i
OR
INFOH.,,ATION NOTICE TO PROPERTY OVTNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnforrnation Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 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 impralement to an
existing structure, you 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 assistingin the construction or improvement of 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 Withhol Tax Law: As an e mployer, you must withhold income taxes from emp loyee wages attime e oyees are d. You will be liable for the tax payments even if you don't actu ally withhold thetax from your employees. For more information,call the Oregon Department of Fleven ue at 378-3390.
Unem lnsurance Tax: As an em ployer,you are required to pay a tax for unemp loyment insurancepurposes on
at 378-3224.
wages all employees. For more information, call the Oregon Emp loyment Division DHR
Workers'Com ion lnsurance: As an e mployer, you are subject to the Oregon Workers,CompensationLaW and must obtain workers compensation insurance for your employees. lf you fail to obtain workers'compensation insurance, you may be su bject to penalties and will be liable for all claim costs if one of youremployees is injured on the job. For more information , callthe Workers' Compensation Division DIF at 873-7434.
U'S' lnternal Revenue Service: As an employer, you must withhold federal income tax from employees,wages.ymentevenifyoLdidn'tactuallywithholdthetax.Formoreinformation,call
the lnternal Flevenue Service at 221-3g60.
OTHER RESPONSIBILITIES AND AHEAS OF CONCERN:
-Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meetcode requirements that may be brought to your atiention through inspections.
Liabi and lnsurance: Contact your insurance agent to see if you have adequate insurancecoverage for accidents an omissions such as falling tools, paint overspray, water damage from pipe punc_tures, fire, or work that m ust be re-done.
Time to Su rvise Em ft/ake sure you have sufficient time to supervise your employees.
Efpertise-' 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 tile appropriate times so they can performthe required inspections.
lf you have additional questions, write to: Corrstruction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621o244J 10t24t89