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MARION COUNTY <br /> Building Application <br /> 5155 Silverton Rd NE <br /> Salem,OR 97305 <br /> Naridir <br /> GOult*.. Permit NA FAX: <br /> FAX: 503-588-7948 <br /> O:R.E G Os N <br /> 555-21-003348-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Hopson Services, LLC <br /> PO Box 51 <br /> Mill City, OR 97360 <br /> , <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: MA3 REP: CHURCH (MAX OCC 80)TEST PITS ON 130 RIVERVIEW ST <br /> Property Address: Parcel: Owner: CHURCH OF GOD OF <br /> 132 E Sorbin Ave,Gates,OR 97346 093E26CC03400- Primary OREGON <br /> Address: PO BOX 647 <br /> ,MILL CI7 OR 97360 <br /> n , ,f y OcENSEI D PROFESS..;', I�AL INFaRATIl3N <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 /> s ` RERMtT FEES iN _ `, t <br /> Fee Description Quantity Amount <br /> Repair(major)-commercial facility 1.00 GPD $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $700.00 <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:04/01/2021 1 std_BuildingApplication pr <br />