Laserfiche WebLink
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 APPLICATIOI~ -~ ~_.q <br /> sul. D,.G[] <br /> <br /> 0 D~LLING ~ ~'0 ~ ~ BUILDING DEMOUTION 0 MINOR EL LAOEL <br />D DW~LING ~BEL D SITE ~N R~I~ D PLUMBING <br />~ MANUFACTURED DWELLING ~ SITE EVALUA~ON ~ MECHANICAL <br />' ~ MANUFACTURED STOOGE ~ SITE ~ALUATION/SEPTIC ~ DRIV~AY <br />~ PRE-FAB ~ SEPTIC ~ INFORMATION <br /> <br /> ~-~- <br />NAME OF APPLICANT: '~O~..K,~:~ '~'-_..S~__ ~.~.l~2:~ PH# ,~O,~- ~ <br /> <br />WORK DESCRIPTION; S I' I 05 ~ ~[_DDt'~"~O~') <br /> <br />( ) ' am performing the work on properly, own or occupy. 5 4¥L_~._~3 <br />( ) lam a registered builder or the authorized representative of a registered builder. 'LV~I~ ~1~:,-,'-('~ <br /> State of Oregon Construction Contractors Board Registration # <br /> FAX# <br /> <br />~ I am the authorized representative of the property owner or contractor. <br /> <br />( ) I will be hidng 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 /> <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 OFFICE USE ONLY: GEOCtI$.TRI~T: FLOOD PLAIN <br /> <br />SUBDMSION: LOT# BLOCK# <br />REV6/19~96 <br /> <br /> <br />