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Home My WebLink AboutPermit Fence 1993-7-27 ...i.. !,~~" FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 Office: INSPECTION LINE: 726-3759 726-3769 ),-i{ l CJ <;a-~ Assessors Map #: . \'l 03~ (\ Owner: LOhYll0 '~t1C41 S Address:f 0 60 j 2-Lp i,./ \ '<\ ~ l )\~-\-e---r\ ~ A0r\ 6() , Value of Fence:_Hl A ), Tax Lot #: '" \ 3SCCJ Job Location: City: State: Phon. *''1+ -- S Iq (V1 sa) ~Br\ Zip: qf\4~ 6_ Fence Permit is $5.00 Con t rae tor IIns tall.",{ _ JC1_I.:J(\~ . Address: Phone #: City: State: Zip: Cons~ruction 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 Development code requirements for fence standards. d~.8~ 7 / ~7/C2-3 Da te / FOR OFFICE USE Oat. of APplieat~on: ') ~P) -93 Receipt # . 0wl~ . Issued Total Amount COllected:~ ,l)(:) , ~B. .,43 ICRA By: ~) - -- Checked for Delinquencies: v- Checked for Historical Status: v--- . ,~......"l. Permit No: q?J \ffi?, Address: d~. f\ (\ ~5a 00 t Issued by:t1fIj)Q ) ~ate: 1}~1/l3 FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law,ORS 701.055(4), requires residential 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, exempt from registration under ORS 701.010(7), need not submit this statement This statement will be filed with the permit. Fill in the ~Iicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: r\ //. - 1. 1"--1-" I 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. 3. A.I I My general contractor is 'Contractor registration number I will instruct my general contractor that all subcontractors who work on the struc" ture must be registered with the Construction Contractors Board. :.R B. If fl 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, I 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 , ~~ 3:2~m. c1L~t9<-) 7 /~/ /C23 ~;)~ig"nature of Permit Applicant Date /' -J 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 - . NOT~:', This !nformcjltion Nqtice;to property Owners About Construction Responsibilities was de~eloped QY the Construction Contractors Board in accordance with ORS 701.055(5), 'passed by the 19.89 Oregon Legislature. If you are acting ~s your own contractor to construct a new home or make a substanti~1 improvement to an existing structur~, you can prevent many problems by being aware of the following responsibilities and areas of concern.' , EMPLOYER RESPONSIBILITIES: If you hire peq;ons not registered with the C;:;onstruction Contractors.Boar~ to do labor in constructing or assisting in the constr~ctio~ or.i.mprovement of aiesidenti~l.structure, you will, i,n most instances, be ruled to be an "employer" ~nd t~e pe'Ople you hire wlUbe "employees". 'As the e,mployer, Y9u mustcomply with the following: . t .. . . . Oregon's Withholding Tax Law: As an emplOYer,. you '!lust withhold income taxes from employee wages at the time employees are .paid. You will be lia~le for the ;ta~' payme,nts even if you don'.t 'actually withhold the tax from -your employees. For more information, call the Oregon Department of Revenue,at 378-3390. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employe~s. ,Forrpore; information,: call the Oregon Employment Division DHR at 378-3224. 1 ~ [ ~; .\ ~ ~ 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 faipo 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 more information, call the Workers' Compens~tion,Division DIF at 373-7434. . ' ;. I: ".. ".- . ,~.. . U.S. Internal Revenue, Ser\(ice: ,As an e'TIployer, you must withhold feder~! income tax from employees' wages. You will be liable for the tax payment even it'you didn'tactually withnold the tax. For more information, call the Internal Revenue Service at 2'21-3960. . OTHER RESPONSIBILITIES AND AREAS OF CONCER~: 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: Contact your insurance ag'ent to see'if you'have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray,' 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 th~y can pe~form the required inspections. . , If you have additional questions, write to: Construction Contractors Board 700 Summer St. NE, Suite, 300., Salem, OR 97310-0151 Phone 503-378-4621 .H 0244J '10124189-~'., :. . '.~I' .' . -.. , . '. ..''::.'."