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?LEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BI: DIRECTED TOQFHE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> BUILDING ~ AG EXEMPT BUILDING t i ELECTRICAL <br />i i DWELLING I I BUILDING DEMOLITION I i MINOR EL LABEL <br /> <br /> [ ~ DWELLING LABEL m I SITE pLAN REVIEW PLUMBING <br /> ~ MANUFACTURED DWELLING ~ SITE EVALUATION ~ MECHANICAL <br /> <br /> [ ) MANUFACTtJR~_D STORAGE [, [ SITE EVALUATION/SEPT[C I ~ DRIVEWAY <br /> ~ r PRE-FAS t,.,__.J SEPTIC INFORMATION <br /> <br />NAME OF APPUCANT:.. <br /> <br />PROJECT ADDRESS_.' <br /> <br />WORK DESCRIPTION: <br /> <br />I am performing 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 o¢ Oregon Construction Contractor's Board Registration # <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 8oard, <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 responsibl)ity of the applicant <br />to assure that all necessary' information hat; 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 />S IGNATURK OF AP?[ICANT: ~.~¢, (/7 ~~/Z <br />FOR OFIqCE ~ ONLY: ~ <br /> <br /> <br />