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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFORMATION AND YOU WILL BI: DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. ~ <br /> <br /> APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> <br /> [] BUILDING O EXEMPT BUILDING [] ELECTRICAL <br /> Il DWELLING L-J BUILDING DEMOLITION LJ MINOR EL LABEL <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] MANUFACTURED DWELLING [] BITE fiVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE [] SITE EVALUATION/SEPTIC [] DRIVEWAY <br /> [] PRE-FAB [] SE.T C [] ,NFO ^T ON <br /> <br />NAME OF APPLICANT; <br /> <br />D · <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 o,r, dl'-~ances relating to building construction. I will authorize <br />a representative of Building In--property for the purpose of making <br />inspections for this permit. <br /> <br />SIGNATURE OF APPLICANT: , <br />FOR OFFICE USE NL Y: GEODISTRJCT: FLOOD PLAIN SUDE HISTORIC W~_ DS ~ LAND USE CASE <br />SUBDIVISION: LOT~ BLOCK# <br /> <br /> <br />