HomeMy WebLinkAboutPermit Fence 1983-8-31
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVIsION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
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AssesS'L)Map #:\Il()50~\ Tax Lot #: oaOrf)
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City: U\Qf\t 00 QQ s::~e: ~)hO ~OD....-ZiP: cnt'2J(2
Value of Fence: \f0~ ~ce Permit is $5.00
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Job Location:
Contractor/Installer:
, 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
Development code requirements for fence standards.
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Date
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FOR OFFICE USE
Date of Application: R:-)\' C3.1JJ.!.OBt:92:J~
Receipt # \D\~~ Issued BY~_1-ffi )
Total Amount Collected: e:; ()~ - - ~
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Checked for Delinquencies:
Checked for Historic~l Status:
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Permit No: C'0 'ffi~
Address: /\ \1,Q- ,\ & 0 0 t
Issued bYC1{ Lf)OJ Date: ~ .,ry (]3
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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
fi led with the permit.
Fill :,n the fPlicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
1. r~ I own, reside in, or will reside in the completed structure.
2. I I I, 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.
:n B. I~;J 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
reverse side of this form.
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Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COpy TO ISSUING AGENCY PERMIT FILE
PINK COpy TO APPLICANT
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INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE:. ..' This Inf()~mation Notice'to Property Owners About Construction Responsibilities"
was developed by the Con~truction Contractors Board in accordance with ORS 701~055(5)',"
passed 'by the 19.89 Oregon Legislature. ' ' ,
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If you are .acting' as your own contractor to cpnstruct a new home or make a substantial improvement to an
existing structure, Y9u can p~event lTl,any prOblems by. being aware of the following respo,nsibilities and areas
of c.oncern. ' '.., -, ' '
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EMPLOYER RESPONSIBILITieS:
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If you hire per~ons not registered with the Construction Contractors Board to do labor in constructing or assisting
in the constr~ction qr imptovement of "a residential.structur~; YO'lf will, in most instances, be ruled to be an
"employer" and the people you hire win be ".employees". As the'employer, you mu~l com.ply with the following:
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Oregon's Withholding Tax Law: . As ,an employer, you, must '!Vithhold 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 Department .of Revenue at 378-3390.
Unemployment Insurance ii-ax: As"~n ~mplo\ier, you are required to:pay a tax for unemployme~t insurance
purposes on the wages of all employees; For more in,Jormahon; ,call the Or~gon EmploymentDivision DHR
'at 378-3224.
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Workers' Compensation Insurance: As an employer, you are subject to the Oregoi:1 Workers' Compensation
Law, and must obtain workers'. compensation insurance for your employees: If you fail to ,obtain workers'
compensation insurance, you maybe subject to penalties and will be' liable for all claim costs ifone of your
employees is injured on the job. For more information, call ~he Workers' Compensation QlvisionDIF at 373-7434.
U.S. Internal F,levenue Service: As an employer, you must withhold federal iJ1come tax from employees' wages.
You wiWbe liable for the tax payrnent eVen j(yOD didn~t actu:ally Withhold the tax. :For more information, ca.ll
the Internal Revenue Service at 2'21-3960'. '.' . I -'. ' '. ,.' . ,
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OTHER RESPONSIBILITIES AND AREAS OF CONCE~Nl~ "
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Code Compliance: .As the'permit holderfor'this project;you,are'responsible for resolving any failure to meet
code -requirements that-may be brought to your attention. through inspections.
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Liability and Property Damage Insurance: COhtact your insurance,agent to'seeifYOl!lhave adequate insurance
coverage for accidents and omissions such as falling tools,' paint overspray~ \'vater damage from pipe punc-
tures; fire, or work that must be re-done.
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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: '
Construction Contractors Board
700 Summ~t S1.. ~E, Suite ~O.o
Salell\;' OR 97310-0151
Phone 503-378-4621
0244.{ '10/24/89' ,
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