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PI.EAS[i FILl_ OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODI: TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> BUILDING ~ AG ~XEMPT BUILDING ~ ELECTRICAL <br /> <br /> DWELLING O{ ~ I ~ ' ' BUILDING DEMOLITION ' ' MINOR EL LABE/ <br /> <br /> ~ DWELLING LABEL ~ ~ SITE PLAN REVIEW ~ ~ PLUMBING <br /> <br /> [ ~ MANUFACTURED DWELLING ; J SITE EVALUATION ~ 4 MECHANICAL <br /> <br /> t~ MANUFACTURED STORAGE ~ [ SITE EVALUATION/SEPTIC ~ DRIVEWAY <br /> ~.J PRE-FAn [ <br /> <br />( ) <br /> <br />PROJECT ADDRESS: <br /> <br /> I ~m pefformin[ ~he work on prope~ 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 # ~ l . <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 />SIGNATURE OF APPLICANT: <br /> <br />AS SOOn as ali 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 />r-oR OFFICe' USE ONLY: <br /> <br />REV 516195 <br /> <br />TAX ACCT#: <br /> <br /> <br />