Laserfiche WebLink
Permit No: <br /> <br />Address: <br /> <br />Issued by:. Date: <br /> <br /> FOR OFFICE USE ONLY <br /> STATEMENT: <br />INFORMATION NOTICE TO PROPERTY OWNERS <br /> ABOUT CONSTRUCTION RESPONSIBILITIES <br /> <br />Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants <br />who are not registered with the Construction Contractors Board to sign the <br />following statement before the building permit can be issued. Licensed Architect <br />and Engineer applicants, exempt from registration under ORS 701.010(7), need <br />not submit this statement. This statement will be filed with the permit. <br /> <br />Fill in the applicable blanks, an._~d initial box 1 and either box 2A or 2B: <br /> <br />I own, reside in, or will reside in the completed structure. <br /> <br />My general contractor is <br /> <br />Contractor registration number ... <br /> <br />I will instruct my general contractor that all subcontractors who work on <br />the structure must be registered with the Construction Contractors Board. <br /> <br />OR <br /> <br />I will be my own general contractor. <br /> <br /> If I hire subcontractors, I will hire only subcontractors registered with the <br /> Construction Contractors Board. If I change my mind and ~1o hire a general <br /> contractor, I will contract with a contractor who is registered w~th the <br /> Construction Contractors Board and w mmediately not fy the off ce <br /> issuing th sbu d ng permit of the name of the contractor. <br /> <br />I hereby certify that the above information is correct and that I have read and understand <br />the information Notice to Property Owners about Construction Responsibilities on the <br />reverse side of this form. <br /> <br />Signature of Permit Applica¢[ /~-'~-'" <br /> <br />Date <br /> <br />CONSTRUCTION CONTRACTORS BOARD <br />0244J 1/90 <br /> <br />WHITE COPY TO ISSUING AGENCY PERMIT FILE <br />PINK COPY TO APPLICANT <br /> <br /> <br />