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ACTIVITY # <br /> <br />PLEASE FILL OUT Tile FOLLOWING INFORMA'i-ION AND YOU WILL BE DIf~ECTED TO THE NEXT <br />AVA,i-ABLE .U,LDING CODE TECHN,C,AN. <br /> <br />NA~ME OF APPLICANT: <br /> <br />P~ROJ~CT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />PLUMB1NG ........ <br /> <br />MECHANICAL <br />DRIVEWAY <br /> <br />( ) <br /> <br />( ) <br /> <br />I am performin$ the work on property I own or oCcupy. <br /> <br />I am a registered builder or the author/zed representative of a re~iste.,red builder. <br />State oF Oregon Construction Contractor's Board Registration # <br />FA×# '~-~'~C:) . ~- <br /> <br />I ~m the au~h0rized representative of ~he properly owner or contra~or. <br /> <br />I will be hiring a general contractor registered with ~he Construction Contractors Board. <br /> <br />This application may go through a simultaneous review proc'ess where zonin§, septic (if a[0piicable) <br />construction requirements are checked prior to issuance of a permit, it is the responsibility of the appticant <br />to assure that ail necessary information has been provided. <br />As soon as all requirements O[ the review h~e ~n me], you wig be notified that your permit ha~ been <br />~ssued and ready to be picked up. , / ~ / <br /> <br />SIGNATURE OF APPLI = . <br /> <br /> <br />