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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 />TYPE OF APPLICATION <br /> [] BUILDING <br /> [~'~' DWELLING <br /> [] DWELLING LABEL <br /> [] MANUFACTURED DWELLING <br /> [] MANUFACTURED STORAGE <br /> [] PRE-FAB <br /> <br />NAME OF APPLICANT: <br /> <br />PROJECT ADDRESS: <br /> <br />WORK DESCRIPTION: <br /> <br />[] AG EXEMPT BUILDING <br />[] BUILDING DEMOLmON <br />[] SITE PLAN REVIEW <br />[-] SITE EVALUATION <br /> <br />[] SITE EVALUATION/SEPTIC <br />[] SEPTIC <br /> <br />[] ELECTRICAL <br /> <br />[] MINOR EL LABEL <br /> <br />[] PLUMBING <br /> <br />[] MECHANICAL <br /> <br />[] DRIVEWAy <br /> <br />[] INFORMATION <br /> <br />() <br /> <br />() <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 authorized representative of the property owner or contractor. <br /> <br />I will be hiring 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 {he responsibility of the applicant <br />to assure that all necessaPj 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 ordinances relating to building construction. I will authorize <br />a representative of Building Inspection to enter on the property for the purpose of making <br />Inspections for this permit. <br /> <br />FOR OFFICE USE ONLY: GEODIBTRICT: FLOOD PLAIN~ BUDE <br /> <br />MAP PAGE: ZONE: CROSS STREET:. <br /> <br />BUBDP,8$1ON: <br /> <br />HISTORIC WETLANDS <br /> <br />LO~ <br /> <br />LAND USE CASE <br />ACCT~ <br /> <br /> <br />