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PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO TI'~IE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS <br /> <br />PH# .~?/-,. ~f../?, <br /> <br />WORK DESCRIPTION: .,,~ <br /> <br />I am peflorming the work on property I own or occupy. <br /> <br />'1 am a registered builder or the authorized representative of a registered builder. <br />State of Oregon Construct{on Contractor's Board Registration # ?,¢~'~ <br /> <br />I am the authorized representative of the property owner or contractor. <br /> <br />I will be hiring a [eneral 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 />A~ 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 APPL CANT:., . , ~ , .. <br /> <br />FOR OFFICE USE ONLY: <br /> <br /> <br />