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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 />TYPE OF APPLICATION <br />  96-09-06 PI,~ :57 <br /> BUILDING [-] AG EXEMPT BUILDING <br /> DWELLING [] BUILDING DEMOLITION <br /> [] DWELLING LABEL [] SITE PLAN REVIEW <br /> [] MANUFACTURED DWELLING [] SITE EVALUATION <br /> [] MANUFACTURED STORAGE [] SITE EVALUATION/SEPTIC <br /> [] PRE-FAB [] SEPTIC <br /> <br />OUT <br /> <br /> ELECI~AL <br />U MINOR EL LABEL <br />[] PLUMBING <br />[] MECHANICAL <br />[] DRIVEWAY <br /> <br />[] INFORMATION <br /> <br />NAME OF APPLICANT: <br />WORK DESCRIPTION: <br /> <br />I am performing the work on property I own or occupy. <br /> <br />I am a registered builder or the authorized representative of a registered builder. <br />State of Oregon Construction Contractor's Board Registration # <br />FAX# <br /> <br />I am the authorized representative of the property owner or contractor. <br /> <br />(/_~ I will be hiring a general contractor registered 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 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 cruces relating to building construction. I will authorize <br />a representative of Building Inspect,kin to~tter on the property for the purpose of making <br />inspections for this permit. /. ~ <br />SIGNATURE OF APPLICANT: ~./~~~ <br /> <br />FOR OFFICE USE : GEO T~ CT:FLOODPLAIN SLID HISTORIC WETLANDS LAND USE CASE <br /> <br />SUBDMSION: LOT# BLOCK# <br />REV &,rg/96 <br /> <br /> <br />