Event Permit For Use Of A Department-Owned Or Managed Building, Grounds Or Parking Area - Oregon Department Of Administrative Services

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Event Permit
For use of a Department-owned or managed building, grounds or parking area
(Event Sponsored by a Private, Non-profit, or Public Entity)
DAS NUMBER: _________________________________
DAS USE ONLY
User name and Organization name
Event / Function Name
User mailing address
Expected Number of Participants
City, State and Zip code
Contact Person Name
Email address
Phone Number
Contact Cell Phone
Approval is hereby granted for the Event / Function indicated above for the following premises:
Premises
Requested:
Event Date /Time
Start Date
Time
End Date
Time
Begin
End
Building Reservation Coordinator agrees by signing this form that user agrees to comply with the conditions
stated in the Event Application and the executed Event Application is made a part of this Permit.
By:
Title:
Date:
Building Reservation Coordinator (of applicable)
By:
Title:
Date:
Department of Administrative Services
Email completed and signed form to: Facilities.Event@oregon.gov
Or mail to: DAS Event Agreements, 1240 Ferry Street SE, Salem, OR 97301-4290
125613 Event Permit 11-2017

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