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PLEASE FILL OUT THE FOLt, OWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPMCATION <br /> <br /> ~J BUILDING ~ ~ AG EXEMPT RUILDING L ~ ELECTRICAL <br /> <br /> ~ ~ DWELLING ~ * BUILDIN(] DEMOLITION ~ I MINOR EL LABEL <br /> <br /> I ~ DWELL NG LABEL ~ I SITE pLAN REVIEW PLUMBING <br /> <br /> t · MANUFACTURED DWELLING I,~3 SITE EVALUATION ~ MECHANICAL <br /> [ ~ MANUFACTURED STORAGE [ I SITE EVALUATION/SEPTIC ~ DRIVEWAY <br /> I I PRE-FAB I I SEPTIC <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />(~) <br /> <br />I am performing the work on propem/I own or occupy. <br /> <br />t am a registered builder or the authorized mp'resentative of a registered builder. <br />State of Oregon Construction Contractor's Board Registration # <br /> <br />I am the authorized representative of the proper~ owner or contractor. <br /> <br />I will be hirin§ a general contraCtor registered with the Construction Contractors goard. <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 necessaq~ 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 />SIGNATURE OF APPLICANT:~ <br /> <br />FOR OFFIC~ USE ONLY: <br />MAPPAGE~ ZONE:~j~ C~O$SSTRI~CT*. <br /> <br />REV 316195 <br /> <br /> <br />