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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 /> I BUILDING <br /> <br /> ~ DWELLING <br /> <br /> i DWELLING LABEL <br /> <br /> ; MANUFACTURED DWELLING <br /> <br /> I MANUFACTURED STORAGE <br /> <br /> J PRE-FAB <br /> <br />AG EXEMPT BUILDING <br /> <br />BUILDING DEMOLITION <br /> <br />SITE PLAN REVIEW <br /> <br />SITE EVALUATION <br /> <br />SITE EVALUATION/SEPTIC <br /> <br />SEPTIC <br /> <br />ELECTRICAL <br />MINOR EL LABEL <br />PLUMBING <br />MECHANICAL <br />DRIVEWAY <br />INFORMATION <br /> <br />NAME OF APPLICANT: ,~-'~'C~v~ r~.~ <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />/X) I am performing the work on property I own or occupy. <br /> <br />( ) <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 review have been met, you will be notified that your permit has been <br />issued and ready to be picked up. <br />SIGNATURE OF APPLI~/~.*~,~v~~~-~~ <br /> <br />MAP PAGE: ZONE: __ CROSS ;: TAX ACCT# <br /> <br />SUBOIVlSION: LOT# BLOClrul <br /> <br />REV 8/3/9S <br /> <br /> <br />