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,;; MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> 503-588-5147 <br /> Couy Permit NA FAX: 503-588-7948 <br /> O R.E G: O.N <br /> 555-22-002725-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Oregon Sewer&Drain <br /> PO Box 1282 <br /> Silverton, OR 97381 <br /> tr- ate"r--'aa.0 4w e <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: MA]REP: 3 BDRM SFD TO REPEL 3 BDRM SFD �6 <br /> Property Address: Parcel: Owner: THOMAS M&JAN E FRITH IT <br /> 9953 North Fork Ln Se, Lyons,OR 97358 093E02DD00800- Primary <br /> Address: 14621 SW GRANDVIEW LN <br /> x G i ENS • P a ` l / kW. [TOE i TIGARD Rao 4. , <br /> Business Name License Address Phone <br /> OREGON SEWER&DRAIN Installer/Pu 38968 PO BOX 1282 SILVERTON OR 97381 (50-3)-874- <br /> mper <br /> License <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:03/30/2022 1 std_BuildingApplication pr <br />