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SESPNEW - 1447533
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SESPNEW - 1447533
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Last modified
2/11/2010 11:56:01 AM
Creation date
7/6/2004 10:02:53 AM
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Template:
Permits
Permit Address
11278 SIMPSON RD SE
Permit City
Aumsville
Permit Number
555-96-04372
Parcel Number
081W20 01300
Permit Type
SESPNEW
Permit Doc Type
Permit Document
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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF ~PPLICATION <br /> <br /> ~ ~ BUILDING ~ , ~ AG EXEMPT BUILDING <br /> <br /> I ~ DWELLING ~ I BUILDING DEMOLITION <br /> ~ I DWELLING LABEL I ~ SITE PLAN REVIEW <br /> I, I MANUFACTURED DWELLING I r'~' SITE EVALUATION <br /> <br /> ~ ,, ; MANUFACTURED STORAGE ~ ~ SITE EVALUATION/SEPTIC <br /> <br /> ~ ~ PRE-FAB ~ SEPTIC <br /> <br />TO THE NEXT <br /> <br />EL~'RICAL <br /> <br />MINOR EL LABEL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />DRIVEWAY <br /> <br />INFORMATION <br /> <br />NAME OF APPLICANT: <br /> <br />PH# ~ ~ =-7 L~ O' :~ q ~ ~ <br /> <br />WORK DESCRIPTION: QL_ cj <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 />{ 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 APPLICANT: /.~. ~/'~~ <br /> <br /> <br />
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