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ACTIVITY # <br /> <br />PLEASIE FILL OUT TIlE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NE×l' <br />AVAILABLE BUILDING CODE TECHNICIAN, <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> ~ DWELLING <br /> <br /> '1 DWELLi G LABEL <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />AG EXEMPT BUILDING <br />BUILDING DEMOLITION <br />SITE PLAN RE¥1EW <br />~ITE EVALUATION <br /> <br />SITE EVALUATION/SEPTIC I i DRIVEWAY <br /> <br />ELECTPdCAL <br /> <br />MINOR EL LABEL <br /> <br />MECHANICAL <br /> <br />I am performing the work on property I own or occupy, <br /> <br />I am a registered builder or the authorized representative of a registered builder. <br />State of Oregon Construction Contractorfs Board Registration # <br /> <br />I am the authorized representative of the property owner or contractor. <br /> <br />I will be hiring a general contractor registered with the Construction Contractors Board. <br /> <br />This application may 8o through a simultaneous review process where zoning , septic (if applicable) and <br />construction requirements are checked prior to issuance of a permit, It is the responsibility of the applicant <br />to assure that all necessary information has been provided. <br /> <br />As soon as all requirements of the review have been met, you wilt be notified that your permit has been <br />issued and ready to be picked up. <br /> <br />SIGNATURE OF APPLICANT:,_._~..-~~O~.~-~'~/ <br />FOR OFFIC~ USE ONLY: <br /> <br />MAp PAGE: ZONE: --. 0R0,$$ STRE~CT: TAX ACCT.': <br /> <br />REV 3/6/9§ <br /> <br /> <br />