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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BI: DIRECTEO 'I"O THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />"F~PE OF APPLICATION <br /> [] BUILDING , [] AG EXEMPT BUILDING [] EI~ECTRICAL <br /> [] DWELLING [] BUILDING DEMOLFaON [] MINOR EL LABEL <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] MANUFACTURED DWELLING [] SITE EVALUATION [] MECHANICAL <br /> [] ~ANUFACTUREO STOP, AGE ' [] BITE EVALUATION/SEPTIC [] DRIVEWAY <br /> [] [] sE.nc [] <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS; <br /> <br />WORK DESCRIPTION: <br /> <br />I am performing the work on property I own or occupy. <br /> <br />I am a registered builder or the author[zed 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 />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 z. oning, septic (if applicable) and <br />construction requirements are checked prior to issuance of a permiL It is the 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 Infom'~ation given Is correct. I agree to <br />coreply 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 makthg <br />inspections for this permit. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />FOR OFFICE USE ONLY: GEODISTPJCT: FLO00 pLAiN SUDE <br />MAP PAGE:.__ ZONE:__ CROSS STREET: <br /> <br />tlISI-ORIC__ WET~a. NDS.__._ L.AND USE C.4. SE~~- <br /> <br /> <br />