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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> •— Salem,OR 97305 <br /> Marron• <br /> Cary. 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <br /> 555-21-011416-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: MATTHEWS DESIGN AND CONSTRUCTION INC <br /> PO <br /> LYONSBOX, OR727 97358-0727 <br /> 7777 _-fr <br /> x ..- ,, ' TYPE=OF 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 MA] REPAIR REPL 1 BDRM WITH NSFD 4 BDRM *SAME FOOTPRINT <br /> r JOB SITE INFORMATION <br /> Property Address: Parcel: Owner: RONALD S&BARBARA] <br /> 11163 Dogwood Cir Se, Lyons,OR 97358 093E18AB01500- Primary CROSS LT <br /> Address: 2775 ARGYLE DR S <br /> SALEM OR 97302 <br /> ' :; . _.;1:ICENS16 PROFESSIONAL <br /> Business Name License Address Phone <br /> POthlit FEES <br /> Fee Description Quantity Amount <br /> Repair(major)-single family dwelling 1.00 Ea $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $700.00 <br /> Note:This may not include all the fees req red 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:11/16/2021 1 std_BuildingApplication_pr <br />