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ACTIVITY # <br /> <br />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 />I I BUILDING I t AG EXEMPT BUILDING <br />~ J DWELLING ' ~ BUILDING DEMOLITION <br />I .,J DWELLING LABEL ~ ~ SITE PLAN REVIEW <br />t J MANUFACTURED DWELLING I t SITE EVALUATION <br /> <br />t J MANUFACTURED STORAGE t J SITE EVALUATION/SEPTIC <br /> <br />[ '1 [ [ <br />[ ~ PRE-FAB [ t SEPTIC <br /> <br />ELECTRICAL <br />MINOR EL LABEL <br />PLUMBING <br />MECHANICAL <br />DRIVEWAY <br />INFORMATION <br /> <br />NAME OF APPLICANT: ~//~/)f} - /'~<': ~ ~ ~/~Y.~v/ ~ ~' <br /> <br />PROJECT ADDRESS: ~ -"~ ~ ~ <br /> <br />PH# <br /> <br />WORK DESCRIPTION: <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 />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 <br />issued and ready to be picked up. <br /> <br />SIGNATURE OF APPLICANT: <br /> ~ <br /> <br />FOR OFFK:~ USE O1~ <br /> <br />revie~ have been m_et, yo~will be notified that your permit has been <br /> <br /> LOT~I BLOCK~ <br /> <br />REV 813/95 <br /> <br /> <br />