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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> County 503-588-5147 <br /> Authorization NA FAX: 503-588-7948 <br /> OREGON - - - XP' <br /> 555 21 000404 A <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-OP <br /> YPE OF WORK <br /> ORK <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: FIRE -AUTH MIN REP: COMMERCIAL 3 EMPLOYEES <br /> JOB SITE INFORMATION ti <br /> Property Address: Parcel: Owner: WJD LLC <br /> 250 Front St N, Detroit, OR 97342 105E01BC15400 - 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 /> Authorization notice- no field visit 1.00 Ea $150.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $250.00 <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 i std_BuildingApplication_pr <br />