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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />~ [] AG EXEMPT BUILDING [] ELECTRICAL <br /> [] DWELLING [] BUILDING DEMOLITION [] 'MINOR Et. LABEL <br /> [] DWELLING LABEL [] SITE PLAN RE'flEW [] PLUMBING <br /> [] MANUFACTURED DWELLING [] SITE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE [] BITE EVALUATION/SEPTIC [] DRIVEWAY <br /> [] P.E- ^B [] SEPTIC [] INfORMATiON <br /> <br />NAME OF APPLICANT; ~ ~ ~'~_.~_ PH# <br /> <br />( ) I am pe~o~ing the work on pro~ I own or ~upy, <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 hiring a general contractor registered with the Construction Contractors Boar~ CX/~ <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 I$ 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 Inspect/on to enter on the property for the purpose of making <br /> <br /> IGNATURE OF APPLICANT: <br /> <br /> <br />