TYPE OF WORK
New construction Demolition
Addition/alteration/replacement Other:
CATEGORY OF CONSTRUCTION
1- and 2-family dwelling Commercial/industrial
Accessory building Multi-family
Master builder Other:
JOB SITE INFORMATION AND LOCATION
Job site address:
City/State/ZIP:
Suite/bldg./apt. no.: Project name:
Cross street/directions to job site:
Subdivision: Lot no.:
Tax map/parcel no.:
DESCRIPTION OF WORK
PROPERTY OWNER TENANT
Name:
Address:
City/State/ZIP:
Phone: ( ) Fax: ( )
APPLICANT CONTACT PERSON
Business name:
Contact name:
Address:
City/State/ZIP:
Phone: ( ) Fax: : ( )
E-mail:
CONTRACTOR
Business name:
Address:
City/State/ZIP:
Phone: ( ) Fax: ( )
CCB lic.:
Authorized
signature:
Print name: Date:
REQUIRED DATA: 1- AND 2-FAMILY DWELLING
Permit fees* are based 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
work indicated on this application.
Valuation
Number. of bedrooms:
Number of bathrooms:
Total number of floors:
New dwelling area: square feet
Garage/carport area: square feet
Covered porch area: square feet
Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Permit fees* are based 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
work indicated on this application.
Valuation
Existing building area: square feet
New building area: square feet
Number of stories:
Type of construction:
Occupancy groups:
Existing:
New:
NOTICE
All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
under ORS 701 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:
Cut (cubic yards):
Fill (cubic yards):
Acreage disturbed:
This permit application expires if a permit i s not obtained within 180
days after it has been accepted as complete
*Fee methodology set by Tri-County Building Industry Service Board
Phone: 503-992-3229 Fax: 503-992-3202
1924 Council Street/P.O. Box 326, Forest Grove OR 97116
Inspection Request Line: 503-992-3206
Permit Number:
Gra
ding P
ermit Application
City of Cornelius
By City of Forest Grove
click to sign
signature
click to edit
![]()
