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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br /> <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br /> TyP~ OF APPLICATION <br />L ILDING ri AG EXEMPT BUILDING ri ELECTRICAL <br />LLING ,,,~ BUILDING DEMOLITION [] MINOR EL LABEL <br /> <br /> [] DWELLING LABEL ~t-~ b~l'E~ PLAN REVIEW r-I PLUMBING <br /> [] MANUFACTURED DWELLING J~'~"SITE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE ~.. F-~ SITE EVALUATION/SEPTIC ~ DRIVEWAY <br /> [] PRE-FAB [] SEPTIC [] INFORMATION <br /> <br /> NAM E O F APPLICANT:~'} ~/~ ~/~'~/ <br /> / <br /> <br /> WORK DESCRIPTION: <br /> <br />(~ I am ~do~ing ~e wo~ on pm~ I ~n or ~upy. <br />( ) I am a ~ls~ bui~er or ~e au~o~ repmsen~flve of a r~ister~ bulmer. <br /> S~te of Oregon Cons~on Controls B~rd Regis~fion <br /> <br /> ( ) I am ~e auto.ed mpmsen~e of ~e pm~ owner or ~n <br /> <br /> ( ) I will ~ hiring a general ~ntmctor ~ister~ w~ ~e Cons~on <br /> <br /> a simul~n~us revi~ p~ss where zoning <br /> ~is appli~fion may go ~mugh <br /> ~n~on r~uimmen~ are ~ked prior to issuan~ of a pe~it. It is ~he ms~nsibili~ of ~e appli~nt <br /> ~ assure ~at all ne~ssa~ in~fi~ has ~en pmv~. <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 />I certify that I have read this application and state that the Information given Is correcL I agree to <br />comply with all state laws and county ordinances relating to building construction. I will authorize <br />a representative of Building Inspection to enter on the property for the purpose of making <br />inspections for thts permiL Y~x/~i '/'~,~*~' <br />SIGNATURE OF APPUCANT~ <br /> ' (/ // _ <br /> <br />REV 6//S,'9~ <br /> <br /> <br />