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MARION COUNTY <br /> Ate= Building Application 5155 Silverton Rd NE <br /> ��arton Salem,OR 97305 <br /> County 503-588-5147 <br /> Authorization NA FAX: 503-588-7948 <br /> O.R.E G:O.N <br /> 555-22-009197-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: PUGSLEY,TOM <br /> PO BOX 344 <br /> AURORA, OR 97002 <br /> .� <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: AUTH W/FLD ADD DAYCARE TO EXIST CHRUCH 15 CHILDREN/2 STAFF <br /> :1,t i, r30 SITE INFORM7iTIQI4iq "TifgW 0 ,, s <br /> Property Address: Parcel: Owner: NORTH MARION BAPTIST <br /> 20687 Highway 99E Ne,Aurora,OR 97002 041W13C 00500-Primary CHURCH <br /> Address: PO BOX 344 <br /> AURORA OR 97002 <br /> :. V LICENSED PROFESSIONAL.INFORMATION a' : ` , <br /> Business Name License Address Phone <br /> a# 9 d Y s t a PERMIT FEES D <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $605.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $705.00 <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:10/06/2022 1 std_BuildingApplication pr <br />