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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOlLOWiNG INFORMATION AND YOU WILL BI: DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> BUILDING L----J AG EXEMPT BUILDING ~ ~ ELECTRICAL <br /> <br /> ~ ~ DWELLING L.---J BUILDING DEMOLITION ~ ~ MINOR EL LABEL <br /> ~ I DWELLING LABEL ~ ~ SITE PLAN REVIEW ~V'"-,~ PLUMBING <br /> ~ ~ MANUFACTURED DWELLING ~ BITE EVALUATION ~ ~ MECHANICAL <br /> ~ ~ MANUFACTURED STORAGE ~ ~ SITE EVALUATION/SEPTIC ~ DRIVEWAY <br /> <br /> ~,-,-~J PRE-FAB ~ ~ SEPTIC <br /> <br />PROJECT ADDRESS: I 0'7 ~"~ "~. u~-}~- q"} ~ ~tJ~ - <br /> <br />WORK DESCRIPTION: /~'~'l;' <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 Contractor's 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 go 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 will be notified that your permit has been <br />issued and ready to be picked up, <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />FOR OFFICE USE ONLY: <br /> <br />MAP PAGE: ZONE: <br />REV 3/6/95 <br /> <br />CROSS S11{i~q': TAX ACCT#: <br /> <br /> <br />