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HomeMy WebLinkAboutPermit Fence 1993-9-3 . . FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUII.DING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 Office: INSPECTION LINE: 726:~ 726-3769 Job Location: 565f)~ MM<.D(c" Q1 Assessors Map #: 1'1- (Jd-- 3f)- on Owner: "R, \<e1~ 0' 1\ )e.; \ \ Address: ( CV::j(j U Yo \0'-1'"11\0.... 'PN IL-- 5~\c\ \ ....1--_ ~ ~ Value of Fence: -:;'::xD :.5~.a J Tax Lot #: Ol9DO Phone #: 74-i "J"30S' cJ:kI d~rv'\ Zip:~4-'7~_ City: State: of< Fence Permit is $5.00 Contractor/Installer: ()w~u (~I \<. 0' t--Je,\\\l Address: Phone #: City: State: Zip: Construction Contractors Registration #: Expires: By signing this permit/application, I agree to call 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 was provided with the Springfield D';r ;~'::;C" foe f,"" """doc',. t;!t;;:, 3 Si~at ~. Date / . / FOR OFFICE USE Date of Application: Q/"?/9.""? /O/SC;-r / Issued By: JOB 1I: 9.~/ ,"?h.~ y/~ Receipt # Checked for Delinquencies: .C- .".- Checked for Historical Status: Total Amount Collected: . . " .,' " . , .. . Permit No:: c:}"2./ 7~"< ~~ ~~ ~Ar?()P-rt:'~ AJj ~~. Date: ~;9.] Address: Issued by' FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . . \ . ~ote: Oregon Law, ORS 701.055(4), requires residenti'al 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, exemptfrom registration, under ORS701.010(7), need not submit this statement This statementwill be filed with the permit.' Fill in the applicable blanks, and initial boxes.1 and 2, and either, box 3A or 3B: . , 1, I~( I own, reside in; orwill reside in ,the completed structure. 2. '1 ~:.. I understand that I must register as a construction contractor if the structure is sold ,or offered for, sale before or upon'completion, ' 3, A. I I My general, contractor is , Contractor registration number I will instruct myge'neralcontractor that all subcontractors who work on'the struc- " ture must be registered with the Construction Contractors Board. . ";, .,:.. OR 3, B, I "'>c::: I I will be my own general contractor, - If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor,1 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 certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the' reverse side of this form. ;C .. q/3~-193 . Date'n ' .. CONSTRUCTION CONTRACTORS' BOARD 0244J 8/91 ' WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ' , . . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . . \, .' . NOTE: . 'r:. l)ii.i? In~t"!a~o!l Notice to Property Owners About Construction Responsibilities was developed by the Co'nstruction Contractors Board in accordance with ORS 701.055(5), ".!'. .' :passed by~th_e 1989 'Oregon Legislature. . ,:' ,\ ',' . .' . If you are acting as your own contractor to construct a new home or make a substanti~(impi:ovenient to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas . . of concern. . . EMPLOYER RESPONSIBiliTIES: ." , If you hire persons not registered with the Construction Contractors Board to do labor in cOQstructing or assisting in the construction or iriiprovem'ent ora 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 whh the following: . " . ". ," '. . ,. ," . ."~' Oregon's Withholding Tax Lciw: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable f<;lr the. tax payments even if yo!:, don't ,actually withhold the tax from your employees. For more information, call the Oregon Departmen\ of Revenue at 378-3390.. Unemploymenllnsurance Tax: As an e~pIOyer, you are required to pay ~ tax for une~ployment insurance purposes on the wages of all employees. For more' information, call the Oregon Employm~DtDivision DHR . .. . .,..- -. at 378-3224.. . ..-.-....-...- ".- - .. Workers' Compensation Insurance: As an employer; you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may. be subject to penalties and'wilibe liable for all claim costs if one of your employees is injured on the job. For more information. call the Workers' Compensation Division DIF at 373-7434. . , U.S. Internal Revenue Service: As an employer, you must' withhold federal income tax from employees' wages. You will be liable for the. tax paym~nt ev~n if Y9u didn;t'atiually withhold the tax. For more information. call the Internal Revenue Service at 221-3960.. . OTHER RESPONSIBiliTIES AND AREAS OF CONCERN: '. ...::::>--.... -. Code Compliance: As the permit holder for thisproject..ytJu are responsible for resolving any failure to meet code requirements that-may be brought to your.attention through inspections. Liability and Properly Damage'lnsurance: Contact your insurance'.agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools. paint overs pray. water damage from pipe punc- tures, 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 of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. . '. . ; If you have additional questions. write to: Conslruction Contractors Board 70.0. Summer SI. NE, Suite 30.0. , Salem, OR 97310.-0.151' Phone 50.3-378-4621 , ~ -. o.244J'lo./24/89 . '.::, ,,',;,. .. i : _,I . j"