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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 />'tYpE OF APPLICATION <br /> <br /> BUILDING ~ AG EXEMPT BUILDING ~ ELECTRICAL <br /> <br /> ~ DWELLING ~--~ BUILDING DEMOLITION ~ MINOR EL LABEL <br /> <br /> * ~ DWELLING LABEL ~ SITE PLAN REVIEW ~ PLUMBING <br /> [, ~ MANUFACTURED DWELLING ~ SITE EVALUATION ~ MECHANICAL <br /> ~ MANUFACTURED STORAGE ~ ~ S~TE EVALUATIONiSEPT[C I ~ DRIVEWAY <br /> ~ ~ PRE-FAB ~ 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 />I am a registered builder or the authoriz,ed 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. <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 wiJl be notified that your permit has been <br />issued and ready to be picked up. <br />SIGNATUREOFAPPLICANT: .,/~'~_ <br />REV 2/1/95 ./// <br /> <br /> <br />