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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INEOIbMATION AND YOU WILL BE DIRECTED 1'0 THE NEXT <br />AVAILABLE BUILDING CODE TECHNICIAN. <br /> <br />APPLICATION SUBMITTAL <br /> <br />'~"PE OF APPLICATION <br /> <br /> [] DWELLING <br /> <br />[] DWELLING LABEL <br /> <br />[] MANUFACTURED DWELLING <br /> <br />[] PRE-FAB <br /> <br />· [] AG ru.XEMPT BUILDING E] EI~ECTRICAL <br />[] BUiLOING OEMOLI'CION [] M{NOR EL LABEL <br />[] SITE PLAN REVIEW [] PLUMBING <br />[] SITE EVALUATION [] MECHANICAL <br />[] SITE EVALUATIONISEPTIC [] DRIVEWAY <br />[] SEP C [] ,. ORMATION <br /> <br />NAME OF APPLICANT; <br /> <br />PROJECT ADDRESS; <br /> <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 /> <br />I am the authorized representative of the ~rope~.~L.~wser or contractor. <br /> <br />('~ I will be hidng a general conlractor registered with the ,Construction Contractors.Bo.~..~. [ _~ <br /> <br />This application may go through a simultaneous review process where zoning, septic (it applicaSlel <br />constnJcfion requirements are c~ecked pdor to issuance of a permiL It is We responsibility of the applicant <br />to assure that all necessary informaUon has been provided. <br /> <br />As soon as ail requirements DJ' [he review have been met, you will be notified that your pen"nit has been <br />issued and rea. dy to be picked up. <br /> <br />I certify that I have read this application and state that the In[on-nation 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 forthis permit. ~ ~ _ <br />SIGNATURE OF APPLICANT~ ~ <br /> <br />FOR OFFICE USE ONLY: GEO~/$_T~IC1-: FLO00 PLAIN SLIDE t~FIIS T~OF#C WETZaANOS .,"Y. ANO USE O!tSE ~ <br /> <br /> <br />