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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Ma/ n Salem,OR 97305 <br /> county Authorization NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> O'.K. E:G O.N <br /> 555-23-009539-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: SCHULER,TIMOTHY <br /> 4837 WILLINGTON CT NE <br /> SALEM, OR 97305 ;; <br /> Aat".,4 5, «n 7 F n pkA <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 TO REPL 2BD SFD W/2BD SFD <br /> .. 1 41.R'`:a ; " ,x``�Ql3 �" FO „MATIQ _ r c- . <br /> Property Address: Parcel: Owner: SCHULER,TIMOTHY <br /> 25537 Taylor Park Rd Se, Lyons,OR 97358 092E10DC01500-Primary <br /> Address: 4837 WILLINGTON CT NE <br /> aa, wu`a ; LICC <br /> Z 7 � N ' Q ESS O AL NOR O o <br /> Business Name License Address Phone <br /> , 3 C fir. ":9�' '. S � E a �':S, <br /> _ a,u..,:. i�. r <..d �`;.aS.. . .. .x" P.OR ,,,, 5.M'C 4 ," ' ?u- x A e. � �.^�. sbats;��, <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $650.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $750.00 <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:11/16/2023 1 std_BuildingApplication_pr <br />