HomeMy WebLinkAboutBuilding Miscellaneous 1990-8-22
,.
~
.
.
.~
..
Permit No: q{)/()tj) L / ^
Address: ~~ ~~M m fOC/J
Issued by(5J Lf}{L) Dat~: ~?IrO
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. 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 applicable blanks, and initial box 1 and either box 2A or 2B:
1. L,lU lil" I own, reside in, or will reside in the completed structure.
2. A. L-.J My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B. ~ 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 (10 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.
~-j 14>-~~J(
Signature of Permit Applicant
y.n.'f()
Daie
CONSTRUCTION CONTRACTORS BOARD
0244J 10/24189
~~ COI'Y TO ISSUING AGENCY PERMIT RLE
\ COpy TO APPLICANT
. .