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ACTIVI1~' # <br /> <br />PLEASE FILL OUT THE FOLLOWING INF. ORMATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECH,NICIAN. <br /> <br /> SUBMITTAL <br /> <br />TyDCLll; APPLICATION <br /> BUILDING · [~] AG EXEMPT BUILDING [] ELECTRICAL <br />DWELUNG [] BUILDING DEMOLr[ION [] MINOR EL LABEL <br /> <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] MANUFACTURED DWELLING [] SiTE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE ' [] S[TE EVALUATIONISEPTIC [] DRIVEWAy <br /> [] PRE-FAB [] SEPTZC [] [NFORMAT[ON <br /> <br />NAME OF APPLICANT; ' PH# <br /> <br />PROJECT ADDRESS; ~:/--3t ~-~JL~,,...,"~c- t,,)-~- l,~.u~"a C~ <br /> <br />WORK DESCRIPTION; ~ &~ck J~ <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 authorbed repmsenLadve of the property owner or contractor. <br /> <br /> I will be hidng 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 permiL It is 'the responsibility of the applicant <br />to assure that all necessary informalion has been provided. <br /> <br />As soon as all requirements of the review have been met, you will be nolJfied~peJTn~ <br />issued and ready to be picked up. <br /> <br />I certify that 1 have read this aoolication., and state that the information g[v~lve <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 p~klng <br />Inspections for this permit. -- <br /> <br />FOR OFFICE USE ONLY: GEO01$ r: FLOOD P(.AJN SUDE __ L~ND USE CASE~ <br /> <br /> <br />