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CITY YALmA. TI. ON I <br /> <br /> Validation: ~ ~ [ <br /> <br />~TE ~L SECTIONS, 1 T~OUGH 4 <br /> DESC~ION <br /> <br />2, LOCATION OF INSTALLATION <br /> <br />'; ~'CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />I sm a CONTRACTOR registered wi~h the State of Oregon. <br />I~s~aes~ Nam~ <br /> <br />! am an AUTHORIZED REPRF~ENTATI~ of the property owner or <br /> <br />cm sqt~a~ footage of project.) Valuation: <br /> <br />(2) ~% S~ Su~h~ge (,05 x Al) <br /> <br />(3) S~c~ ~ Renew 665% x Al) <br /> <br />=$ <br /> <br />' ' l~h~by cecffy that the above informalion is com~. <br /> ' ~ ~ ~n-~sfe~le ~d expire if w~k is not s~ wi~in 180 days of issu~ce or if work is sus~ for 1~ ~ys. <br /> <br /> ~ ~A~llc~t: ~ .Da~: ~ <br /> ~ 15-~ Rev 1~5 <br /> <br /> <br />