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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILLBEDIRECTEDTO THE NEXT <br />AVA,,.AB,.E .U.LD,NO CODE l&LJr <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> BUILDING ~ AG EXEMPT BUILDING ELECTRICAL <br /> <br /> : ~ DWELLING ~ BUILDING DEMOLITION ~ t MINOR EL <br /> ~ ~ DWELLING LABEL t ~ SITE PLAN REVIEW ~ ~ PLUMBING <br /> ~ · MANUFACTUREO DWELLING ~ BITE EVALUATION ~ I MECHANICAL <br /> ~ ~ MANUFACTURED STORAGE ~ ~ SITE EVALUATION/~;EPTIC ; r DRIVEWAY <br /> I I PRE-FAB ~ SEPTIC: <br /> <br />NAME OF APPLICANT:---~"(~ ~ PH# ~'-~ ~)~ <br /> <br /> WORK DESCRIPTION:"~.~ .~ <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 Contractods Board ReBistration # <br /> <br />I am the authorized representative of the property owner or contractor. <br /> <br />I will be hiring a general contractor regiftered 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 necessa~/information has been provided <br /> <br /> As soon as all requirements o[ the review have been met, you will be notified that your permit has been <br /> issued and ready to be picked up. <br /> <br />'x~ SIGNATURE OF APPLICANT: ~-.~ ~(~) ~ ~L~-~.,, , _ <br /> FOR OFRICE' USE ONLY: <br /> <br />REV3/6/95 <br /> <br /> <br />