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BUILD - 1466777
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BUILD - 1466777
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Last modified
2/1/2013 1:40:19 PM
Creation date
8/9/2004 2:24:27 PM
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Template:
Permits
Permit Address
22675 BUTTEVILLE RD NE
Permit City
Aurora
Permit Number
555-96-08087
Parcel Number
041W05 00800
Permit Type
BUILD
Permit Doc Type
Permit Document
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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 /> APPLICATION SUBMITTAL <br /> <br />~--1 DWELLING ~-1 BUILDING DEMOLmON [] MINOR EL LABEL <br />[] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br />[] MANUFACTURED DWELLING {-~ SITE EVALUATION [] MECHANICAL <br />[] MANUFACTURE~ STU~.~GE [] srrE EVALUA~OmS~C [] DmVEWAY <br />[] PRE-FAB [] SEPTIC [] INFORMATION <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br /> ~ ~ PH# <br /> <br />) I am performing the work on pmperb/I own or ~py. <br /> <br />( ) <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 /> <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 ora 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:~ ~ r <br /> <br />FOR OFFICE USE ONLY: GEODISTRICT: FLOOD PLAIN SUDE_~ HISTORIC <br /> <br />MAP PAGE: ZONE: CROSS STREET: <br /> <br />SUBDIVISION: LOT~. <br /> <br />WETI_ANDS.___ LAND USE CASE,__ <br /> TA~ ACCT# <br /> <br /> <br />
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