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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> AtaJlOrt Salem,OR 97305 <br /> County 503-588-5147 <br /> Authorization NA FAX: 503-588-7948 <br /> OREGON <br /> 555-21-000284-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: FRANK MASSER AND CHERYL GRIBSKOV <br /> 2516 62ND AVE SE <br /> SALEM, OR 97317 <br /> TYPE OF WORK ', �� ._.,.. :-„4514, ; <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: FIRE-AUTH REPLACE 2 BDRM SFD WITH SAME IN SAME LOCATION <br /> JOB SITE INFORMATION . ` <br /> Property Address: Parcel: Owner: <br /> 50617 Linnwood Dr,Gates,OR 97346 09S03E26CD00203 - Primary <br /> Address: <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> PERMIT FEES <br /> Fee Description Quantity Amount <br /> Authorization notice- with field visit 1.00 Ea $450.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $550.00 <br /> Note: This may not include all the fees required for this project. <br /> EXPIRED <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:01/12/2021 std_Bu dingApplication_pr <br />