CATEGORY OF CONSTRUCTION
Single Family
ADU
Sign
Townhouses
Commercial
Multi-Family (3 or more)
Duplex
Industrial
Detached Accessory Bldg.
Other
TYPE OF CONSTRUCTION
New
T.I.
4 Demo
DESCRIPTION OF WORK:
JOB SITE INFORMATION AND LOCATION
Job site address:
City:
State:
ZIP:
Map no.:
Lot no.:
PROPERTY OWNER
Name:
Address:
City:
State:
ZIP:
Phone: - -
Fax: - -
E-mail:
Signature: Date:
This installation is being made on residential or farm property owned by a member of my
immediate family or myself and is exempt from licensing requirements under ORS 701.010.
Signature: Date:
CONTRACTOR
Business name:
Address:
City:
State:
ZIP:
Phone: - -
Fax: - -
E-mail:
CCB license no.:
Print name:
Signature: Date:
APPLICANT
Name:
Address:
City:
State:
ZIP:
Phone: - -
Fax: - -
E-mail:
Signature: Date:
City Approval By: Date:
City Title:
VALUATION / CONSTRUCTION INFORMATION
Required Data 1-2 Family Dwelling
Valuation of Project: $
Number of Floors:
Number of Bedrooms:
Number of Baths:
New Dwelling area square footage:
Garage / Carport area square footage:
Deck / Covered Porch area square footage:
New Building Height (feet/inches):
Other structure area square footage:
Required Data Commercial
Valuation of Project: $
Number of Stories:
New Building area square footage:
Existing Building area square footage:
New Building Height (feet/inches):
Occupancy Groups - Existing: New:
All contractors and subcontractor’s are required to be licensed with the Oregon
Construction Contractors Board under ORS 70 and may be required to be
licensed in the jurisdiction in which work is being performed.
BUILDING PERMIT AND RELATED FEES
Plan Review Fee
$
Fire Life Safety
$
Planning Department Review Fee
$
Fire Department Review Fee
$
Engineering Department Review Fee
$
(a)Subtotal
$
Date Paid
Receipt No.
Building Permit Fee (BP)
$
State Surcharge (12% of BP Fee)
$
Investigation Fee (Charged on a time & material basis)
$
Water SDC Fee
$
Sewer SDC Fee
$
Storm SDC Fee
$
Transportation SDC Fee
$
Proportionate Share
$
Recording Fees
$
Construction Site Permit
Other
$
Construction Excise Tax (1% of Valuation)
$
Additional Plan Review Fee
$
Other
$
(b)Subtotal Building/SDC Fees
$
Date Paid
Receipt No.
Grand Total of Fees Collected (a + b)
$
Structural (Building) Permit Application
PERMIT NUMBER:
City of Hood River
211 2
nd
Street, Hood River, OR 97031
Phone: 541-387-5202
Inspection Line: 541-387-5211
Schedule Inspections Online: BuildingPermits.Oregon.gov
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if
work is suspended for 180 days.
Electronic Signatures and Similar Markings are Recognized as a Legal Binding Signature by the City of Hood River and the State of Oregon. ORS 84.0001 to ORS84.061