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o ACTIVITY # <br /> <br />PLEASE FILl. OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br /> APPLICATION SUBMITTAL <br /> <br /> , AG EXEMPT BUILDING <br /> <br />t .~ DWELLING LA~E[ /~ : SITE P~N REVIEW <br /> <br />L----.J MANUFACTURED DWELLING ~ -~ , SITE EVALUATION <br />~ MANUFACTURED STORAGE ~ BITE EVALUATIONIBEPTIC <br />~ I PRE-FA8 ~ SEPTIC <br /> <br />NAME O.F APPLICANT.~ <br /> <br />WOR.K DESCRIPTION: <br /> <br />t · ELECTRICAL <br />L,, ~ MINOR El. LABEL <br />i J PLUMBING <br /> <br /> ~ MECHANICAL <br /> L--J DRIVEWAY <br /> <br />~ ~ iNFORMATION <br /> <br />I am performing the work on property I owh or occupy. <br /> <br />I am a registered builder or the authorize,0 iepresentative of a registered builder. <br />State of Oregon Construction Contractor'~l.B. oard Registration # <br />FAX# ' ' <br /> <br />I am the authorized representative of the prgper~y owner or contractor. <br /> <br />I wiJi be hiring a generaJ contractor registe;red 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 pFovided. <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 />gIGNATURE OF APPLICANT: <br /> <br /> <br />