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ACTI¥1TY #. <br /> <br />PLEASE FILL OUT, T.H[ fgLLg~lHg IHi:O[MfiTIO~/~D YOU WILl I~1~ BIRI~CI'I~B 1'0 TH[ ~[~T <br />AYAILABLI: BUILDING CODE TECHNICIAN. <br /> <br /> APPLICATION SUBMITTAL <br /> <br />TyPE OF APPLICATION <br /> <br /> eUILDING ~ ~ AG EXEMPT P. Uli. DING ~ t ELECTRiCAl. <br /> <br /> ~ i DWELLING ~ I BUILDING DEMOLITION I 1 MINOR EL LABEL <br /> <br /> ~ ~,l DWELLING LABEL ~ SITE pLAN REVIEW ~ -. } PLUMSING <br /> ~ MANUFACTURED DWELLING [ ~ SITE EVALUATION ~ ~ MECHANICAL <br /> <br /> ~ ~ MANUFACTURED STORAGE ~. · SITE EVALUATION/SEPTiC ~ DRIVEWAY <br /> ~ ! PRE-FAB ~--J SEPTIC ~ ~ INFORMATION <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ,ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />( ) <br /> <br />I am pedorming 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 Contractor's Board Registration # ~/~ ~ (...'~- <br />F^X:~_ ~I~ - <br /> <br />I am the authori~,ed representative of the property owner or contractor, <br /> <br />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 requiremects of the review have been met, you will be notified that your permit has been <br />issued and ready to be picked <br /> <br />FOR OFF~ U~ ON~Y: <br /> <br />MAP PAGE: ZONE: Cl~OS~ ~'TR~e'r:., TAX ACCT# <br />SUI~II;)IVL~ON: LOll. BLOCKS <br /> <br />R~'V Sl3~5 <br /> <br /> <br />