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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 />APPLICATION SUBMITTAL <br /> <br />TYPE OF APPLICATION ~-,// <br /> <br /> ~ DWELl. lNG [] BUILDING DEMOLITION [] MINOR EL LABEL <br /> <br /> [] DWELLING LABEL [] SITE PLAN REVlL~V [] PLUMBING <br /> [] MANUFACTURED DWELLING [] SiTE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE [] SITE EVALUATION/SEPTIC [] DRIVEWAY <br /> <br />NAME OF APPLICANT: ~R/J ~ ~/,2¥~;~';0~ ~-- [~?~ <br /> <br />WORK DESCRIPTION: R.~ ~ ~ &~ <br /> <br />~) lam peffo~ing the wo~ on prope~, own or =upy. ~ ~ y ~ ~ = <br /> <br />, am a registered builder or the authorized representative of a registered builder. Oregon <br />State of 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 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 /> <br />FOR OFF CE NL Y: GEOD S CT: FLOOD PLAIN SLIDE HISTORIC V~:TLANDS <br />SUBDMSION: LO Tti <br /> <br />TA,~ ACT USE <br /> <br /> <br />