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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAIl, ABLE BUILDING CODE TECHNICIAN, <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> ~ BUILDING ~ AG EXEMPT ~UILDJNG ~l ] ELECTRICAl. <br /> <br /> ' ~ DWELLIN(] ~ BUILDING DEMOLITION I ~ MINOR EL LABEL <br /> <br /> ' ~ DWELLING LABEL ~ SITE PLAN REVIEW PLUMaING <br /> <br /> MANUFACTURED DWELLING ~ SITE EVALUATION ~ ~ MECHANICAL <br /> <br /> t I MANUFACTUREO aTORAGE ~ SITE EVALUATIONJSEPTIC I I DRIVEWAY <br /> ~ ~ PRE-FAB I.---J SEPTIC <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 />State of Oregon Construction Contractor's Roard Registration # <br /> <br /> ) I am the authorized representative of the property owner or contractor~ <br /> .2 I will be hiring a 8eneraJ contractor re§istered with the Construction Contractor~ Board. <br /> <br />This application may 8o throu§h 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 />issuedandreadytobepickedup. 3 . ~.~.~. <br />SIGNATURE DE A?PLICANT: ..... / ~.~/(~'.::~2 ~ <br />~R 0~' USE ONLY: <br /> <br />R~ 316195 <br /> <br /> <br />