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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> 97305 <br /> 'Galway Sale 503-,OR588-5147 <br /> -5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <br /> 555-21-010382-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: DANIEL BUSS <br /> 1914 37TH AV NW <br /> SALEM, OR 97304 <br /> "TYPE O�.WO"RK"" <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 3 BDRM RES WITH NSFD 3 BDRM *SAME FOOTPRINT <br /> y . <br /> Property Address: Parcel: Owner: ELKHORN CORP <br /> 34893 North Fork Rd Se, Lyons,OR 97358 084E31 00100- Primary <br /> Address: 2009 NE BRAZEE <br /> __.... PORTLAND OR 97212 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> S <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:10/14/2021 1 std_BuildingApplication_pr <br />