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Permit No: <br /> <br />Address: <br /> <br />Issued by:, <br /> <br />Date: <br /> <br /> STATEMENT: <br />INFORMATION NOTICE TO PROPERTY OWNERS <br />ABOUT CONSTRUCTION RESPONSIBILITIES <br /> <br />Note: Oregon Law, ORS 701.055(4), requires residentiai 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, and initial box I and either box 2A or 2B: <br /> <br /> I own, reside in, or will reside in the completed structure. <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 contractO~'; <br /> <br /> If I hire subcontractors, I will hire only subcontractors registered with the <br /> Construction Contractors Board. If I change my mind and (Jo hire a general <br /> contractor I will contract with a contractor who is registered w~th the <br /> Construction Contractors Board and w mmediately notify the office <br /> issuing this building permit df 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 />Sig~atbre of Per-~it App~ <br /> <br />Dale ' <br /> <br />CONSTRUCTION CONTRACTORS BOARD <br />0244J 10/24/89 <br /> <br />WHCI'E COPY TO ISSUING AGENCY PERMIT PILE <br /> COPY TO APPLICANT <br /> <br /> <br />