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BUILD - 1463940
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BUILD - 1463940
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Last modified
2/4/2013 9:25:10 AM
Creation date
8/9/2004 1:15:08 PM
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Template:
Permits
Permit Address
7475 SHERMAN RD SE
Permit City
Aumsville
Permit Number
555-97-00428
Parcel Number
081W29A 00800
Permit Type
BUILD
Permit Doc Type
Permit Document
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PLEASE FILL OUT THE FOLLOWING INF. OI:bM. ATION AND YOU WILL BE DIRECTED TO THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. ~ ~ ~',~S <br /> <br />APPLICATION SUBMITTAL <br /> <br />'I-YPE.O F APPLICATION <br /> ' BUILDING - [] AG EXEMPT BUILDING [] E[.ECTRICAL <br /> DWELLING [] BUILDING DEMOLF(ION [] MINOR EL LABEL <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] MANUFACTURED DWELLING ' [] SITE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE ' ~] SITE EVALUATION/SEPTIC [] DRIVEWAY <br /> [] PRE-FAa [] SEPTIC [] INFORMATION <br /> <br />NAI'AE OF APPLICANT: <br /> <br />PROJECT ADDRESS; <br /> <br />WORK DESCRIPTION; 5'-/-,~.,~ Z~/J~II~.,1 <br /> <br /> o <br />( ) I am pedo~ing ~e wo~ on pr pe~ py. ~ <br />(X) I am a regislered builder or ~e authored representative o[a register~ builder. <br /> State of Oregon Cons~cdan Con~actoYs Beard Reg[s~on ~ f I~& l / . <br /> <br />( '} I am the auto.ed represeam~ve o~ the prope~ owner or mnmctor. <br />( ) I will be hidng 8 general Cn~ctor register~ wiB Be Cons~on Con~ctom Board. <br /> <br />~is app[i~on ~y go ~rough a simultaneous review press where zoning, sepUc (if appli~ble) <br />~ns~cdon r~uirements are ~ed pdor to issuan~ of a peril It is ~e res~nsibili~ <br />to assure ~at all ~ssaW infOm~[o~ has been provided. <br /> <br />As soon as all requirements of the review have been met, you will be nodfied that your permit has been <br />issued and ready to be picked up. <br /> <br />[ 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 maklng <br />inspections for this permit. <br /> <br />SIGNATURE OF APPLICANT: ~ ~.~z..v,.~--~'- ~'aZ d'c~.¢f <br /> <br />FOR OFFICE USE ONLY: GEODI$ ~RICT: FLO00 <br />MAPPAGE:_~. ZONE:~f~UC~OS$$rREET': <br /> <br /> <br />
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