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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YoU wILL BI: D~I~r~TED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br /> A PuCATION su m ttau <br /> <br />~ ~ APPLICATION <br />~ [,,,,,, r AG EXEMPT BUILDING ~ ELECTRICAL <br /> <br /> WELLING ~ t BUILDING DEMOLITION r ~ MINOR EL LABEL <br /> <br /> ~ ~ ,, ,, ', ,, <br /> ~ DWELLING LABEL BITE PLAN REVIEW PLUMBING <br /> <br /> I I MANUFACTURED DWELLING ~ ~ SITE EVALUATION ~ ~ MECHANICAL <br /> <br /> i I MANUFACTUreD STORAGE ~ ~ SITE EVALUATION/SEPT{C ~ DRIVEWAY <br /> <br />NAME OE APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />( ) am performing the work on property I own or occupy. <br /> <br />yJ"~-fi-am a registered builder or the authorized representative of a registered builder. <br /> State of Oregon Construction Contractor's' Board Registration # '~(~ "'7 ~ <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 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/2been met, you will be notified that your permit has been <br />SIGNATURE OF APPLICANT: , <br /> <br />SUBOiVISIOB: <br /> <br />REV 5116195 <br /> <br /> <br />