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[] BUILDING ~ [] AG EXEMPT BUILDING L~ ELECTRICAL <br /> <br /> [] DWELLING [] BUILDING DEMOUTION [-~ MINOR EL L~SEI.. <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] MANUFACTURED DWELLING [] SITE EVALUATION [] MECHANICAL <br /> [] MANUFACTU"ED STORAGE [] SITE EVALUATION/SEPTIC [] DRIVEWAY <br /> [] PRE-F^S [::] S nC [] ,.FDR ATID. <br /> <br />N~A. ME OF APPLICANT, ~ ~,-~ w t~' -~x_~4 (:~ ,,- PH# <br /> <br />( ) I am performing the work on property I own or occupy. <br /> <br />() <br /> <br />I am a recjistered builder or the authedzed representative of a registered builder. <br />State of Oregon Construction Contractors Board Regisbation # ~.'~' <br />FAY~ <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 of a permiL It is ~he 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 thls 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~ze <br />,a__r_e_p~r.e,s_en~?~v.e, .o[Bui~,d?ng Inspection to enter on the property for the pu~~g <br /> <br /> <br />