Laserfiche WebLink
MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> count Site Evaluation NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> QR:E'G ON <br /> 555-24-005043-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: OSE541 LLC <br /> 40110 Providence Dr <br /> Scio, Or 97374-9736 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: SE: 3 BDRM SFD&4 BDRM ADU <br /> "la _ F ,. n n a �° '. . ' 08 SITE INFORMA .. s* As .` A f�� <br /> .m -a;f F`.i�^ �a,�,�rt�.:»s a�- � ., `�A ���' ,'�. �«e���.c.ls�.�'a�cee�,au.,«..i'...;�. �n M <br /> Property Address: Parcel: Owner: BURNS,THOMAS R& <br /> 2611 Jory Hill Rd S,Salem,OR 97306 083W20B 01400- Primary BURNS, ROXIELLIA L <br /> Address: 2611 JORY HILL RD S <br /> SALEM OR 97306 <br /> �� P � M a .�''�€ °y a r:. p ��s� ,ns, °,�� .,. ay.a:� ��?�Nre a,r �a:r fl�",;�!P'" � ��i"-t3 a a� � -�g� '�• _ �` <br /> £ - „ ,. I . .LIKENS D PROFESSI'ONAL:INFORMATIOI�t, . g r F9 r , . ,. . <br /> Business Name License Address Phone <br /> OSE541 LLC Installer 39705 40110 PROVIDENCE DR SCIO Or 541-362-7000 <br /> License 97374-9736 <br /> WAiOa; rav':., a.,..it ,. <br /> Fee Description Quantity Amount <br /> Site evaluation-Single family dwelling 1.00 Ea $890.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $990.00 <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:07/01/21724 1 std_BuildingApplication_pr <br />