Illegal Activity Complaint Form

What are you reporting?
What type of work is being performed?
Painting/Lead Based Paint Removal Plumbing
Flooring Electrical
Siding Roofing
Excavation Concrete
Fencing Paving
Remodeling Gutters
Interior Tree Removal/Trimming
Other - Describe Below
Oregon Jobsite Information
Is there an active jobsite? Yes No
Are you the property owner? Yes No
Street Address
When was the jobsite last active? (MM/DD/YYYY)
Contractor Information
Contractor Name
CCB License Number
Brief explanation of what the contractor is doing:
Your Contact Information
Name Phone Number Email Address
Do you want a call-back Yes No