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PLEASE FILL OUT TIlE FOLLOWING INFORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECIINICIAN. Q ~)~ ~(~ <br /> APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION <br /> BUILDING t t AG EXEMPT BUILDING , ELECTRICAL <br />! ~ DWra~-mIG ; ~ BUll.DIN.(] DEMOLITION I ~ MINOR EL LABEL <br />~ DWra ! .qQ LABEL ~" SITE PLAN REVIEW LUMBINQ , <br />~ ! MANUFACTURED DW~ING ~ ~ SITE EVALUATION MECHANICAL <br />t--~ MANUFACTURED ~rORAQE ~ SITE EVALUATION/SEPll~, ; ~ DRIVEWAY <br />~ ~ PRE-FAB SEPTIC I I INFORMATION <br /> <br />NAME OF APPLICANT; <br /> <br />PH# ~;"[ ~-- } ~a;~ <br /> <br />PRO,JECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />( ) <br /> <br />State of Oregon Construction Contractor's Board Registration # OO"~'7.¢~ <br /> <br />I am the authorized representative of the property owner or contractor. <br /> <br />( ) <br /> <br />( ) I will be hiring a general contraL'tor 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 h. as 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 />SIGNATURE OF APPLICANT: /~/~. 6'7~.o ~/ J~ <br /> <br />REV ~'3~5 <br /> <br /> <br />