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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WiLL BE DIRECTED TO THE NEXT <br />AVAILABLF BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> ~ BUILDING ~ AG EXEMPT BUILDING t ~ ELECTRICAL <br /> <br /> [ ~ DWELLING ~ BUILDING DEMOLITION ~ * MINOR EL LABEL <br /> ~ ~ DWELLING LABEL ~ .SITE PLAN REVIEW I ~ PLUMBING <br /> [ I MANUFACTURED DWELLING ~ .SITE EVALUATION I ~ MECHANICAL <br /> <br /> ~ MANUFACTURED.STORAGE ~, ~ .SITE EVALUATION/SEPTIC L--_J DRIVEWAY <br /> I I PRE-FAB · I 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 authorized representative of a registered builder, <br />State of Oregon Construction Contractor'sSoard 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 t~view 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 p~ovided, <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 />SIGNATURE OF APPLICANT: <br /> <br />FOB OFRCEUSE ONLY: <br /> <br />MAP PAGE ZONE: ~ C~OSS S~l~rl': TAX ACCT <br /> <br />,SUB~4WSION: LOTI __ <br /> <br />~EV 511Slg$ <br /> <br /> <br />