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MARION COUNTY <br /> -== J Building Application 5155 Silverton Rd NE <br /> Marron Salem,OR 97305 <br /> County 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <br /> 555-22-004608-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: American On Site <br /> 31881 S Hwy 213 <br /> Molalla, OR 97038-0857 f 1't`�T <br /> 3�.,ie�� �M.�-�' ...,5sv�.�k.., <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: MA]ALT REPL 3 BDRM RES WITH 2 BDRM HOME SAME FOOTPRINT <br /> Property Address: Parcel: Owner: ALEXANDR KRAVETS <br /> 1760 Boones Ferry Rd Ne,Woodburn,OR 051W196 00900- Primary <br /> 97071 Address: 1115 GOOSE CREEK RD <br /> WOODBURN OR 97071 <br /> h LICENSED PROFESSIONAL INFORMATION �� _ , <br /> Business Name License Address Phone <br /> AMERICAN ON SITE Installer/Pu 38346 31881 S HWY 213 MOLALLA OR (50-3)-829- <br /> mper 97038-0857 <br /> License <br /> 3 fi <br /> -' ..kv ,� k s e; pew- (, ,. <br /> PERMIT FEES _ ,f�.. <br /> Fee Description Quantity Amount <br /> Alteration(major) 1.00 Ea $675.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $775.00. <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:05/24/2022 1 std_BuildingApplication pr <br />