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tik.,.- MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> Counter 503-588-5147 <br /> Permit NA N. FAX: 503 588 7948 <br /> OREGON `t <br /> 555-21-000401-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Bethel Excavating <br /> PO Box 504 <br /> Turner, OR 97392 <br /> TYPE OF WORK <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- MAJ REP: 3 BDRM SFD <br /> JOB SITE INFORMATION <br /> Property Address: Parcel: Owner: POWER,DAVE W <br /> 105 1St St W, Detroit,OR 97342 105E02AD00500- Primary <br /> Address: 1295 12TH ST SE <br /> SALEM OR 97302 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> BETHEL EXCAVATING Installer 36198 PO BOX 504 TURNER OR 97392 (50-3)-743- <br /> License <br /> PERMIT FEES <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:01/14/2021 1 <br /> std_BuildingApplication_pr <br />