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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> t ~ BUILDING <br /> ~ ~ DWELLING <br /> i ~ DWELLING LABEL <br /> I I MANUFACTURED DWELLING <br /> <br /> L.-~J MANUFACTURED STORAGE <br /> L---.J PRE-FAR <br /> <br />AG EXEMPT BUILDING ~ t ELECTRICAL <br />BUILDING DEMOLITION ~ * MINOR EL LABEL <br />SITE PLAN REVIEW ~ ~ PLUM~ING <br /> <br />SITE EVALUATION t.,.,._J MECHANICAL <br />SITE EVALUATION/SEPTIC ~ ~ DRIVEWAY <br />SEPTIC <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: ~ ~"y..~w.~'~ <br /> <br /> t"')"'--~ am perf°rming the w°rk °n property I °wn °r °ccupy· ~-~_ <br /> lama registered builder or the authorized representative of a registered builder, <br /> State of Oregon Construction Contractor's Board Registration # <br /> FAX# <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 rev, jew have been met, you wiJl 'be notified that your permit has been <br />issued and ready ~be picked u/~~ __ <br />SIGNATURE OF APR~g~/~ - <br /> <br />FOR omc( USE OIIt1~i" ~~ / ' <br />MAP PAGE:._,..~ ~all~, C~O~.~ S'TP,,I~r: . . AX ACCT <br />Sue[xvt.gum: ~ I~1-1 BLOCK/ <br /> <br />REV 5116195 <br /> <br /> <br />