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ACTIVITY# <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL Bi: DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br /> APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> ~ ~ BUILDING ~ I AG EXEMPT BUILDING I I ELECTRICAL <br /> ~ I DWELLING ~ ~ BUILDING DEMOLITION ~ ~ MINOR EL LABEL <br /> ~ ~ DWELLING LABEL ~ I ~ITE PLAN REVIEW ~, ~ PLUMBING <br /> <br /> MANUFACTURED DWELLING [ r SITE EVALUATION ~ MECHANICAL <br /> <br /> L.~,,~ MANUFACTURED STORAGE ~ ~ SITE EVALUATION/SEPTIC I ~ DRIVEWAY <br /> L,--J PRE-FAIl ~ ~ SEPTIC <br /> <br />NAME OF APPLICANT: <br /> <br />pROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />( ) <br /> <br />( ) <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's Board Registration # ,,, <br />FAX# <br /> <br />I Bm 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 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 />issued and ready to be picked up. <br /> <br />FOB BFRCE USE~LY: <br />MAP PJG~- <br /> <br />REV 5116195 <br /> <br />Z01E I~OSS ~I'REEI': 'i'AX AC~'T ~- <br /> <br />£OT# BLOCi~ <br /> <br /> <br />