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•1/4,'" MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> 1�1c1?O11 Salem,OR 97305 <br /> County 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OR-EGON <br /> 555-22-000208-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> • <br /> Applicant: VAN WINKLE, DANIEL <br /> 1759 SE 61ST DR <br /> HILLSBORO, OR 97123 <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 REPAIR REPL 2 BDRM SFD <br /> � .., : JOB SITE INFORMATjoN <br /> Property Address: Parcel: Owner: BELL, NEONTA M <br /> 22806 Jennie Rd Se,Lyons,OR 97358 092E18DA00600-Primary <br /> Address: 22806 JENNIE RD SE <br /> LYONS OR-97358 <br /> -LICENSED PROFESSXO1NAL INFORMATION <br /> Business Name License Address Phone <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:01/10/2022 1 std_BuildingApplication pr <br />