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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />r~CTRICAL <br /> <br />MINOR EL LABEL <br /> <br />Pt. UMBING <br /> <br />MECHANICAL <br /> <br /> [] MANUFACTURED STORAGE [] SITE EVALUATIONIS~OT7 [] DRIVEWAY <br /> '"" <br /> <br /> WORK DESCRIPTION; 43~"q-/~/~'-- / ~J~.O~ / .- -,' <br /> <br /> ('~\ I am performing the work on property I own or occupy. <br /> ( ) I am a registered builder or the authorized representative of a registered builder. <br /> ~-- z'Y") State of Oregon Construction Contractor's Board Registration # . <br /> <br />~( ~"-'"'~m the authorized representative of the property owner or contractor. <br /> ( ) I will be hiring a general contractor registered wlth tho Construction Ce.tractors Boarl./ ~.~ ~ ~ ~ll~Q~ <br /> '[his 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 responsibiliht of t ah~.~ioant~ <br /> to assure that all necessary information has 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 />I certify that I have read this application and state that the information given is correct. 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 this permit. ~j~ ~/ <br />SIGNATURE OF APPLICANT: . <br /> <br />FOR OFFICE USE QN~f: GEODIST~CT,~FLOOD PLAIN S~DE. HISTORIC WETL ANDS J~.~ ~D U,,~E <br /> <br /> <br />