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;,, " MARION COUNTY
<br /> - v Building Application 5155 Silverton Rd NE
<br /> Btion� Salem,OR 97305
<br /> County Permit NA 503-588-5147
<br /> FAX: 503-588-7948
<br /> O R.E'G:O N
<br /> 555-21-008421-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 L��f 1/
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<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] REP 4 BDRM SFD TO REPL 4 BDRM
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<br /> Property Address: Parcel: Owner: NOICE,PATTY COLLEEN
<br /> 120 North Santiam Hwy,Gates,OR 97346 093E27DA01900-Primary
<br /> Address: PO BOX 615
<br /> . �-- CICENS D PROSES ONAC TNFOR ATIOH. MILL CITY OR 97360
<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
<br /> License
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<br /> RM EEC
<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 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:0e/19/2021 1 std_BuildingApplication_pr
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