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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 />  '~BU]LDING AG EXEMPT BUILDINO ELECTRICAL <br />'-'~ F'] DWELLING [] BUILDING DEMOLmON [] MINOR EL LABEL <br />I--I DWELLING LABI3. [] SiTE Pr. AN REVIEW [] PLUMBING <br />[] MANUFACTURED DWELUNG [] SITE EVALUATION [] MECHANICAL <br />[] MANUFAGTURED STORAGE [] SITE EVALUATION/SEPTIC [] DRIVEWAY <br />[] [] <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br /> PH# <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 />( ) 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 permiL It is ~he responsibility of the applicant <br />to assure that all necessa~/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 ordinances relating to building construction. I will authorize <br />a representative of Building Inspection to enter on the property for the purpose of making <br />inspections for this permit. / / <br />SIGNATURE OF APPLICANT:~<~/_~ ~_/~ <br />FOR OFF~CE USE ONLY: GEOD~TRICT; FLO00 PLAIN SUDE HISTORIC <br /> <br />MAP PAGE: <br /> <br />SUBINVISION: <br />REV Eff~g$ <br /> <br />WETLANDS.~ LANO USE CASE.__ <br /> <br /> TA,~ACCT~ <br /> <br /> BLOCK~. <br /> <br /> <br />