New construction
Addition/alteration/replacement
Demolition
Other:
1- and 2-family dwelling
Accessory building
Master builder
Name:
Address:
City/State/ZIP:
Phone:
APPLICANT
Business name:
Contact name:
Address:
City/State/ZIP:
Phone:
E-mail:
Project name:
Lot no.:
ARC HITECT/DESI GNER
Business name:
Address:
C
ity/State/ZIP:
Phone:
CCB
Lic
No.:
Authorized Signature:
Print name:
Email
City/MetroBus
Lic
No.:
Date:
This permit is issued under OAR 918-460-0030. This permit application expires if a permit is
not obtained within 180 days after it has been accepted as complete.
B
u
il
d
ing Permit Appl
ication
City of Cornelius
TYPE OF WORK
CATEGORY OF CONSTRUCTION
Commercial/Industrial
Multi-family
Other:
JOB SITE INFORMATION AND LOCATION
DESCRIPTION OF WORK
PROPERTY OWNER
CONTRACTOR
square feet
square feet
square feet
square feet
Valuation
$
Number of bedrooms:
Number of bathrooms:
Total number of floors:
New dwelling area:
Garage/carport area:
Covered porch area:
Deck area:
Other structure area:
square feet
Permit fees* are bas ed on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
wo rk i ndicated on this application.
square feet
square feet
Valuation
$
Existing building area:
New building area:
Number of stories:
Type of construction:
Occupancy groups:
Existing:
New:
REQUIRED DATA: 1-AND 2- FAMILY DWELLING
Permit fees* are based on
the v alue of
the work performed. Indicate the
value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead, and
the profit for the
work indicated on
this application.
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
NOTICE
All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
under ORS
70 I
and may be required to be licensed in the
jurisdiction in which work is being performed. If the applicant
is exempt from licensing, the following reasons apply:
BUILDING PERMIT FEES*
Please Refer To Fee Schedule
Fees Due Upon Application
Amount Received
Date Received
Permits expir
e if work is not started within 180 days or if
work is suspended for 180 days.
* Fee methodology set by Tri-County Building Industry
Service Board
1924 Council Street/P.O. Box 326 Forest Grove, OR 97116
Phone 503-992-3229 Fax 503-992-3202
Inspection Request Line 1-888-299-282 1
Job site address:
City/State/ZIP:
Suite/bldg./apt. no.:
Cross street/directions to job site:
Subdivision:
Tax map/parcel no.:
By City of Forest Grove
Permit Number
E-mail:
ENGINEER
click to sign
signature
click to edit
![]()
