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DWELL - 1455150
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DWELL - 1455150
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Last modified
2/1/2013 11:42:50 AM
Creation date
7/21/2004 11:02:47 AM
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Template:
Permits
Permit Address
10499 CHAMPOEG RD NE
Permit City
Aurora
Permit Number
555-96-05349
Parcel Number
041W06A 01300
Permit Type
DWELL
Permit Doc Type
Permit Document
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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 />[] BUILDING [] AG EXEMPT BUILDING [] ELECTRICAL <br />.~ DWELLING [] BUILDING DEMOLITION [] MINOR EL LABEL <br />[] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br />[] MANUFACTURED DWELLING [] SITE EVALUATION [] MECHANICAL <br />[] MANUFACTURED STORAGE [] SITE EVALUATION/SEPTIC [] DRIVEWAY <br />[] PRE-FAB [] SEPTIC [] INFORMATION <br /> <br />NAME OF APPLICANT; <br />WORK DESCRIPTION: <br /> <br />() <br /> <br /> performing the work on property I own or occupy. ~r.~~(~.,,~ <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 /> <br />I am the authorized representative of the property owner or contractor. <br />I will be hirings general contractor registered with the Construction Contractors Boa% <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 /> <br />I certify that I have read this application and state that the information given is correct. I agree to <br />comply with all state laws and county o~'l~nces relatlngto'~uilding construction. I will authorize <br />a representative of Building Inspe~,ron/{o ente,¢ on/'the/property for the purpose of making <br />Inspeotions for this pa..it. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> // <br /> <br />SUBDIVISION: LOT# BLOCK# <br />REV 8/3/95 <br /> <br /> <br />
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