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HomeMy WebLinkAboutPermit Fence 1997-2-12 ,,- .\ ..: SI?RINGFIIELD . . 1 .@Jij)J@j3jff}{~II]I!EfJrr=ll{fJ-j;,~::;"~h;,~';! ";::L~j";" >'. ~ 000'1 ^'~ ~tlll ~ ' , FENCE PERMIT APPLICATION CIty OF SPRINGFIELD BUILDING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: 31 r; '3 O'~0~ Assessors Map u: 170)3/13DO Owner: "S'l\ 0. ...,.\I.....v S' \\ ~\ /l, v Address:3i'D3 O'R S-\- CitY:~(\'^S:fl.\(J State: Value 0 f Fence: J It rJO ~-t Tax Lo t #: / 0 0 Phone #: '1 LfL( SG]l Zip: a/L/IY o.~ Fence Permit is $5.00 Contractor/Installer: ~e..'~ Address: Phone #: City: Sla te: 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 ",as provided ",ith the Springfield ~zements for fence standards. -::z. /J 77 Signatm-e ,/' Date FOR OFFICE USE ~ , Date of Application: 1../ J) /q-:::;- (52 LfS___'\i" To tal Amount CoHec ted:..s; 5:. () c) Checked for Delinql1encies:~ JOB #: q 70J-4'-f Issued By:J. {kfJJ/\ ---- Receipt U Checked for Historical Status: fl~/ ;-'\ Permit #: Address: Issued by: Date: Statement: Information 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 and 2, and either box 3A or 3B: l0. lawn, reside in, or will reside in the completed structure. I I 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. u 3A. 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. OR ~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 that the above information is correct and that I have read and do understand the Information Notice to ~ ;7 -Z'lruction Responsibilities on the reverse Sid~f th~;m91 (Signatur~f per-ntit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) '"l f"'~. '. K!riJ1olrma1fto@1l'il U\!I@to(C~ fto PIr@rP~rity COJw!l1l~rr$ AIb@Mft C@!l1l$ftlrM(CftO@1l'i1 1R~$~@Il'i1$olbo~oftn~$ Note: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. IEM PlO VIEIRl1RlIESPONS~ Bi Ul'UES~ If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in 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: Orcgoll1l's wdthll110llddng 11:ax llaw: As an employer, you must withhold income taxes from employee wages at the time employees are paid, You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept: of Revenue at 945-8091. lUll1lcmplloymcll1lt ill1lsur2lIrnce t2lx: 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 Diyision at the Department of Human Resources at 378-3524. - Workers' compeJfllSauon llllllSUll"all1lCe: 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 will be liable for all claim costs if one of your employees is injured on the job. For tilore information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. u.s. .J[ll1ltemallRevenuc Sennce: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold'the tax, For more information, call the Internal Revenue Service at 1-800-829-1040. OT~1E1Rl RIESPONS~I8l~U1U:S AND AREAS Of CONCIEIRlN~ Code compBiaJlllce: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections, ! Liability ami property damage dnsuJIrance: Contact your insurance agent to see if y,ou have adequate insurance coverage for accident.; and omissions such as falling tools, paint overspray, water da~age from pipe pu~ctures, fLre, 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 coordi.nate the work of rough-in and finish trades, and to-rlOtify building officials at the appropriate times so they cari perform th~ required inspections. If you h~ve additional questions, write or Gall the Construction Contractors Bom:d (PO Box 14140, Salem, OR 97309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own,pm4 1/94 +j'