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City of Woodburn Building Improvement Programs Application Applying For: Exterior Grant Interior Grant Design Services Façade Energy Efficiency Applicant Information Name: Phone: Tax ID Number: Property Owner information Property Address: Name: Phone/Email: Address: City: ST: Zip: Owners Signature: Date: Business and/or Project Information URA Name of Business: Business Owner’s Name: Address: Phone: City: State: Zip: Type of Business: Upper Floor Use: Proposed Improvements Application Date: Approval Date: Amount Awarded: Description: Estimated Cost of Improvements: $ Amount Requested: Building Improvement Program Façade (Downtown) Energy Efficiency ---PAGE BREAK--- CERTIFICATION BY APPLICANT The applicant certifies that all information provided in this application is true and complete to the best of the applicant’s knowledge and belief. The applicant represents to the city that this agreement has been duly authorized by all necessary action on the part of the applicant and no other corporate or other action on the part of the applicant is legally required. If the applicant is not the owner of the property to be rehabilitated, the applicant certifies that is has legal authority to sign and enter into an agreement to perform the proposed work on the building. Evidence of this legal authority must be attached. Applicant acknowledges and agrees the agency shall have no obligation to pay any persons providing materials or performing labor or to cause the release of any mechanics or other liens that may be recorded against the above property in connection with the proposed improvements Applicants Signature Date ACKNOWLEDGEMENT BY PROPERTY OWNER (IF DIFFERENT THAN APPLICANT) The Property Owner hereby acknowledges all the above terms of this application and agrees that the agency shall have no obligation to pay any persons providing materials or performing labor or to cause the release of any mechanics or other liens that may be recorder against the above property in connection with the proposed improvements Property Owners Signature Date Staff Use Only Documents needed: Project Budget Contractor Bids (if they have