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ACTIVITY #.__ <br /> <br />PLI:ASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> APPLICATION SUBMITTAL C~/~'_ f ~ ~L, ff~ <br /> <br />TYpE OF AppUICAT1QN <br /> <br /> LDING I ~ AG F~CE~PT BUILDING L~ ELECTRICAL <br /> <br /> Z ~, DWELLING ~ BUILDING DEMOLITION ~ MINOR EL LABEL <br /> <br /> ~ ,,,.J DWELLING [.ABEL ~ SITE PLAN REVIEW 'L~l.J PLUMBING <br /> · ~ MANUFAGTURED DWELLING ~ SITE EVALUATION I MECHANICAL <br /> ~ MANUFACTUREO STORAGE I z SR'E EVALUATIoN/SII"PTIC i J DRIVEWAY <br /> i t PRE-FAB ~ SePTIC ~ z INEORMATION <br /> <br />NAME OF APPLICANT: ./~/,../¢-dC"/L//~J~.. ~¢//¢'--.¢/-~'/¢/¢~ PI'I~/~"/'/' ¢¢-....~"/f <br /> <br /> I am ~rforming the work on prope~ I own or ~cupy. <br /> <br />( <br /> <br /> I am a reBistered builder or the authorized mpresent:atlve of a registered builder, <br /> State of Oregon Construction Contractor's Board Registration # <br /> <br /> ' am the authorlzed repro*ntative of the prol:~rty owner or COntraCt.% .. _ <br /> <br />Thi~ application may 8~ through a simultaneous review press where zonm~'~ (i¢ ~pplic~ and <br />CORSTrUCT[O~ requirement~ are checked prior to Issue~ of a permit. It i~ the responsibility o~ the applicant <br /> assure that ell necess~ Jn~ormatio~ has ~ee~ pr~ided. <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 />FOR OFFIC~ ~ DI~Y; <br /> <br />REV 8/'3/'95 <br /> <br />LO~ "' OC.~ <br /> <br /> <br />