The URL can be used to link to this page

Home My WebLink AboutPermit Fence 1997-1-23 -- -.-,?;, ~::::':~::::.':.h._ ' .' i~ r. .' . . . ... .... ~PIRIi\lGFIIELD' 1 '@]jJ{f:.~'.~."a '0' ..~a .,.....:..,.~.o.o,: " ;'\' .,' v .... .;. D.'o 0 (]. '.' '\\ . 'C. 0:: . . , ' 0 0... 0 "u 0 cP 0'0 ...:,' .' .... . '''''. '.' '" '.... .. "II " '~. ..,.... .;...~~.. '.,..,' 0 . ~;"~~ ,,, ': .:', ,'" C' :" ';, 0 ~ll,,;r;,:'\:.,i1l~!t!?J;, ry~. ',~;.p~ ._~~' -d~,?d,l ~, :.:. ~:.f~ ~...bV " o .~\ 0.1 . '~':' FENCE PERMIT APPLICATION C1TY OF SPR1NGF1ELD BUILDING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 .-, 9 L./ <'"'" 51 s T rJ J '.:- " -- . . / ./ Job Location: d / ~.) .'r~, _, ~-J rJ I /...../ 'C"/o( Assessors Map #: I 70 '233 -;:s - () / '7D t:J;.x Lot #: Owner: hcral'/ ~-o.~? "'-"A/ -f SH (LP5fL.1J J Address: Phone #: ;{ fir; i?x- 97 _ City: FI.Ilc"C'"~ / State: (/V-o Zip: Value of Fence: 2.0 O'u Fence Permit is $5.00 Contractor/Instal"Ter: ---..... \ .op o. '. -- Add res.::> . ''1 .~, I --t.' . i 't ... " ,r;-/ ~;:: i::J i / /- Phonp l/:' City:- ) r-'~// ""5j?Jr' v..c; / / 't': 1& / I Construction Contractors Registration #: St;:!tp' x C//- J Expires: By signing this permit/application, I agree .to call for aninipe~tion once my fence has been constructed (726-3769). I alsri stated that all information on this application/permit is correct and that I was provided with the Springfield Development code requirements for fence standards. Signature f (/~~ -~. . Date / ~2..s '"'" 77 , FOR OFFICE USE Date of Application: I /~) /9 "7 I Receipt jf () ALf3 7S Total Amoun t ;ollec ted.15, 0 0 Checked for Delinquencies': n Oh..L- Issued By: JOIl #:c- q '7 Df ~ 7 rJ.m iJA Checked for His torical Sta tus: -fj.J).f/I.R. 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 Conti-actors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permitso Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), ' need not submit this statement. This statement will befiled with the permit. . Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: li 1. 1 own, reside in, or will reside in the completed structure. . u 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 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 U 3B. I 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 Property Owners about Construction Responsibilities on the reverse side of this form. L (/~, !('i,\/- . f' (Sig~P~rmit applicant) )-2"3 -'17 (Date) (White copy to issuing agency permit file, ' pink copy to applicant) i., '. .-:.=.- Irllformaiioll1 Notice te' Property OWll"llelr$ , AbolUlt ConstlJ"!lJctioll"ll,ReslPol!1lsibn~ntnes Note: This Information Notice to Property O"rne~s about Construction Responsibilities 'was developed by the Construction ContractorsBoard b! accordance with ORS 701.055(5)0 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 b.t?ing a~are of the following responsibilities and areas ofQoncern., " , , , EMPLOYER R,ESPO~$~B~UlilES:', If you hire persons not registered with the Cons,truction Contractors Board to do labor in construc~ing or assisting in the, construction or improvement of a residential structure, you wi~r, in most instances, be ruled to be an employer and the people you hire will be employee's..As the employer, you must COlTiply :vith the following: ' Oregon's withholding tax law: As an employer, you must withb'old income 41xes 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, caU the Oregon Dept. of Revenue at 945-8091. ' Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of aU employees, For more infarrnation, call the Oregon Employment Divi~ion at the Dep~ment of Human R~sources at 378-3524. ' ' Workers' compensation insurance: As an employer, you ~~ subject ~o 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 b(ybur employees is injured on the job. For'more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. ,u.s. Internal.Revenue Service: ,As an employer,.you,must withhold Jederal income tax ,from employees' wageso 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. OTHER RESIPONS!IB~Ul~fES AND AREAS OIFCONClERN: Code compliance: 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 and property damage insurance:o Contact your insurance agentto, see, if you have adequate insurance coverage for accid~nt, ?-nd omissioilS such as failing tools, paint ov~rspray, water damage from pipe punctures, 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 h~ve theexpertise'to act as your own general contractor; tdcoordinate the work ~f rough-in and finish trades, and to notify building officials at the appropriate times so they canperfdIlIJ: the required inspections. ' ' M ; - .' '. ...... -- ,.... ~. ..,.oj.. ., If y'0p l)ave additionanjuesrions, write or call the Construction Contr<!ctors,~o~rg (P,dBQ?C\14~140,Salexh, OR 97309-5052, 503/378-4621), The Board is located at 700 Summer St. NE Suite 300, in Salem. ' prop-own,pm4 1/94 "