At approximately 16:00 PDT, a homebuilt RV-4 lost power on departure from North Bend and was damaged in the ensuing forced landing near Coos Bay. The pilot, who built the aircraft, was seriously injured. The pilot said there were 6 gallons of fuel in the left tank and 16 gallons in the right tank at the time of departure. He said the engine lost power about 1,000 feet agl while running on the left tank. The inspector said he could neither see nor smell any fuel in the aircrafts left tank, but that the right tank, which was breached, did contain fuel. North Bend reported a temperature of 17 C and a dewpoint of 9 C, which are conditions conducive to moderate to serious carb icing.