HomeMy WebLinkAboutPermit Fence 1997-2-18
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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
Job Location: jqq()
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Assessors Map II: /70 _-=? 'J s-tf.3
owner:p..l ~ ,1/n-rA /IRA';
Addre~s: .91) ~.~,f(~r;
City: /~Q'.O() State~
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Value of Fence: OO'~r r Fence Permit is
.tftt fo-d
Tax Lo t II:
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Phone
II: 7i 77037
Zip: 97#1
$5.00
Contractor/Installer: to /A-<-'VI.1A /
Address: lo/9tJ Jr4-;!Q
City:~L.. -:...,,&-" D .Q State: ~. .
const~ntractors Registration II:
Phone
II: 7'17 d-O 31
Zip: 97'-17"7
Expires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I olso 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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SiMature
d-/J-97
Date
FOR OFFICE USE
Date of Application:.:J-lK..... C,i
Receipt II O:;l.l-lSc,..,
Total Amount coilec~e~:.1t
JOB ll: q 7o~5q
Issued By:OI . rY\t1 c..ku cl 0
Checked [Cll' Delinqupnr;es:
5.60
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Checked for lIistol'ic~l St~t\lS:
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Permit#: Q70dSQ
Address: \ q q D SCo -tt' 'i?""" l'\- \.:L
Issued by: n _ 01(4' ~ruJ.O Date: _~ -I K -0.2
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:
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1. 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.
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3A. My general contractor is
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(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
!Kl 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
N.tlre #A~ rif:::'"; R~p'M;bm.~.. Ow ""re, 'm;~.;,: 97
V (Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
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Note: This Information Notice to Property Ovmers about Construction Responsibilities
was del'elop~d by tlte COllstruction Contractors Board;n accordance with ORS 701.055(5).
If you are acting as your own contmctor to construct a new home or make a substantial improvement to or. c"i,ting stmc:'lre,
you can prevent many proble,ms by being aware of thc following responsibilities and areas of concern.
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If you hire pcrsons not registered with the Construction Contractors Board to do labor in CtlnSlntcting or assisling in the
constmction or improvement of a residential ,tructure, 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:
Cl'2gC,1'S wif.::.o!:!ir.g ~x [~w: As an employer, you must withhold income taxes from employee wages at the time emplo)"ees
are paid, You will be liable for the tax payments even if you don't actually withhold the tax from your employees. Fur mor,'
information, co]] the Oregon Dept. of Revenue at 945-8091,
~hemyloymenl inst:ire~ce ~x: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wagcs of all employees, For more information, call the Orcgon Employment Division at the Department of Human Resource s
at 378-3524.
W:>l'k~~'s' cm:l!lensatio:1 i:1$un:~ce: As an employer, you are subject to the Oregon Workers' Compensation Law. ami :'1:"t
obtain workers' compensati01 insurance for your cmployees, If you fail to o':>tain worker,' compensation insuranc" y"u 11',:
be subjcct to pcnalties and will be liable for all claim costs if one of your employces is injured on the job. For mllr" inr"nn.ltit. I.
callthe Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888,
U.S. ~n,ernz.i ~evenu~ Se.-vic~: As an employer, you must withhold fedenil income tax from cmployees' wages. You win he
liable for the tax payment even if you didn't actually withhold the tax. For more information, can the Internal Revenue Scrvice
at 1-800-829-1040,
OnllE~ ~fS?O;\:SH3~: .r~'iES t\~:::> t\~IEf.\S OF CO;IJCIF.P,lil!:
Code compli:mce: 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. . I
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Liability and property damage insu~ance: Contact your insurance agent to see if you have adequate insurance coverage for
accident.; and omissions suc;, as falling tools, paint overspray, 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 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 requ~red inspections..
If you'have addiiional questons, write or call the Construction Cont~ctors Board (PO Box 14140, Salem, OR 97309-5052.
503/378-4621). The Board is located at 700 Summer Sl. NE Suite 300, in Salem.
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