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MARION COUNTY <br /> Silverton Rd NE <br /> Building Application 5155 Salem,OR97305 <br /> M <br /> Cora?ty Authorization NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-21-001453-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: MILLER,ROSS 3 <br /> 35425 RUTH ST <br /> LYONS, OR 97358 <br /> TYPEtiF WORK <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: FIRE-AUTH W/FLD REPL 3 BDRM RES W/NSFD 1 BDRM *SAME FOOTPRINT <br /> OB SITE II FORMATION _ � <br /> Property Address: Parcel: Owner: MILLER,ROSS J <br /> 35425 Ruth St Se, Lyons,OR 97358 084E32BD03100- Primary <br /> Address: 35425 RUTH ST <br /> LYONS OR 97358 <br /> LICENSED PROFESSIONAL INFORMATION m, <br /> Business Name License Address Phone <br /> HOPSON SERVICES,LLC Installer/Pu 39227 PO BOX 51 MILL CITY OR 97360 (50-3)-897- <br /> mper License <br /> a.. PEEtC+ T FEES. �: • <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $450.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $550.00 <br /> Note:This may not include all the fees required for this project. <br /> This application will expire if application acceptance cannot be achieved within 180 days. <br /> All provisions of laws and ordinances governing this type of work will be complied with <br /> whether specified herein or not. <br /> All persons or entities performing work under this application are required to be licensed <br /> unless exempted by ORS 701.010. <br /> Printed on:02/18/2021 1 std_BuildingApplication pr <br />