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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 /> I [ BUILDING t ] AG EXEMPT BUILDING ~ ] ELECTRICAL <br /> ~ [ DWELLING ' [ BUILDING DEMOLITION L_._J MINOR EL LABEL <br /> <br /> ~ ~ DWELLING LABEL ~ ~ SITE PLAN REVIEW I ~ PLUMBING <br /> t ~ MANUFACTURED DWELLING [ [ SITE EVALUATION t J MECHANICAL <br /> [ ~ MANUFACTURED STORAGE ~ ~ SITE EVALUATION/SEPTIC [ ,I DRIVEWAY <br /> ~ ~ PRE-FAB [ ~ SEPTIC [ ~ INFORMATION <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />( ) <br /> <br />( ) <br /> <br />( ) <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 # ci~c~ > <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 <br />issued and ready to be picked up. <br /> <br />been met, you will be notified that your permit has been <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />FOR OFFICE USE ONLY: <br /> <br />MAP PAGE: CROSS STREET: TAX ACCT# <br /> <br />REV 8/3195 <br /> <br /> <br />