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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion— Salem,OR 97305 <br /> county 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> O RE`G ON <br /> 555-23-000172-PRMT <br /> www.co.marion.or.us - building@co.marion.or.us <br /> Applicant: Owen Construction, Inc. <br /> P.O. Box 21150 <br /> Keizer, OR 97307 <br /> TY s ,. <br /> PE o_ woK • <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: NEW INSTALL 4 BDRM SFD <br /> 747'37—$. : JOB SITE INFORMATION • a �I <br /> Property Address: Parcel: Owner: MICHAEL SEAMAN <br /> 9371 Donald Ln Se,Turner,OR 97392 TEMP MC- Primary <br /> Address: 1453 JORDAN DR SE <br /> SALEM OR 97302 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> OWEN CONSTRUCTION,INC. Installer 38534 P.O.BOX 21150 KEIZER OR 97307 (50-3)-390- <br /> License <br /> PERMIT FEES <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 1.00 GPD $1,010.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,110.00 <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:01/06/2023 1 std_BuildingApplication pr <br />