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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 />~ [] AG EXEMPT BUILDING [] ELECTRICAL <br /> [] DWELLING [] BUILDING DEMOLITION [] MINOR EL LABEL <br /> [] DWELLING LABEL [] SITE PLAN REVIEW [] PLUMBING <br /> [] MANUFACTURED DWELLING [] SITE EVALUATION [] MECHANICAL <br /> [] MANUFACTURED STORAGE [] SITE EVALUATIONISEPTIC [] DRIVEWAY <br /> [] eRE-FAa [] SE~nC [] <br /> INFORMATION <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION; <br /> <br /> ,am pe orm,ng the on prope , own or o up . <br /> <br />() <br /> <br />I am a registered builder or the authorized representative of a registamd builder. <br />State of Oregon Construction Contractor's Board Registration # e/~, o~ <br />FAX~ <br /> <br />() <br /> <br />() <br /> <br />I am the authorized representative 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 permit. It is the responsibility of the applicant <br />to assure that all necessary information has been provided. <br /> <br />As soon as ail 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 ordinan~9~ relating to building construction. I will authorize <br />a representative of Building Inapec~on t.,o,"/dnter on the property for the purpose of making <br />inspections for thts permit.. ,///~//. <br /> <br />FOR OFFICE USE ONLY: GEODISTRICT: F~PLAIN HISTORIC WETLANDS LAND USE CAS~__ <br /> <br />SUBDIWSION: <br /> <br />LOT# BLOCK# <br /> <br /> <br />