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ACTIVI~ Y # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU 'WILL gE DIRECTED TO THE NExT <br />AVAILABLE BUILDING COOI: TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> I ~ ~.UILDING <br /> ~ DWELLING <br /> <br /> ~ ~ DWELLING LABEL <br /> j I MANUFACTURED DWI~LLING <br /> ~ r MANUFACTURED ~TORAGE <br /> i ~ pRE.FAB <br /> <br />AG EXEMPT BUILOING ~ ~ ELECTRICAL <br />BUILDING DEMOLITION I ~ MINOR EL LABEL <br />SITE PLAN REVIEW i i PLUMBING <br />SITE EVALUATION u,,, ~ MECHANICAL <br />SITE EVALUATION/SEPTIC I i DRIVEWAY <br />SEPTIC <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />PH# <br /> <br />I am performing the work on property I own o~' occupy. <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 /> <br />I will be hiring a 8eneral 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 o{ 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 />~iGNATURE OF APPLICANT: ~:.. ~///'~ <br /> <br />FOR OI~ICE USE ONLY: <br /> <br />MAP PAGE: . ZOI~E: __ [ARO$$ ~TRI~T: <br /> <br />TAX ACCTI: <br /> <br />REV 316199 <br /> <br /> <br />