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BUILD - 1464417
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BUILD - 1464417
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Last modified
2/4/2013 9:31:03 AM
Creation date
8/9/2004 1:21:15 PM
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Permits
Permit Address
11495 MCCLELLAN LN SE
Permit City
Aumsville
Permit Number
555-97-00996
Parcel Number
092W13DA01400
Permit Type
BUILD
Permit Doc Type
Permit Document
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ACTIVITY # <br /> <br />PLEASE FILL OUT THE FOLLOWING INFOR/vlATION AND YOU WIt~. BE DIRECTED 'FO THE NE~ <br />AVAI~B LE BUILDING CODE TECHNICIAN. ~ <br /> APPLICATION 5UBMITTA <br /> <br />TYPE OF APPLICATION <br /> [~L BUILDING .0 AG EXF. MPT BUILDING r~ ~ECTRJCAL <br /> ~ DWELLING ~ BUILDING DEMOLITION ~ ~INOR EL ~BEL <br /> ~ OW~LING ~BEL ~ BITE P~N R~I~ ~ PLU~81NG <br /> ~ ~ANUFAC~REO DWELLING ~ SiTE ~ALUATION ~ MECHANICAL <br /> ~ ~ANUFAC~RED STOOGE ~ SITE ~ALUA~ONfSEPTIC ~ DRIV~AY <br /> ~ PRE-FAB ~ SEP~C ~ iNFORmATION <br /> <br />NAMJ~ OF APPLICANT; ~ '.,~'t~,~ PH# <br />pROJECT ADDRESS: <br /> <br />WORK DESCRIPTION; <br /> <br />I am a registered builder or Ihe authorized representative ot' a registered builder. <br />State o1' Oregon ConsLrucLion ConLractods 8nard Registration # <br />FAX# <br /> <br />) [ am [he authored represenb~tive or' the property owner 0¢ con~ctar. <br /> <br />) { will be hid~g a general oonlmctor registered with the ConsthJction Contractors Board. <br /> <br />This appJic_,~tion 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 ~he responsibi~it7 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 />! certify that I have read this application and state that the Information given Is correct. I agree <br />comply with alt state {Bws and coun~ ordinances relating to building construction. ! will authorize <br />a representative of Buiiding'thspection to enter on the proper~ for the purpose of making <br />inspections for this permit. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> <br />
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