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• <br /> MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> aY1D ,, Salem,OR 97305 <br /> county Permit NA FAX:FAX: 503-588-7948 <br /> 0!it EG0 N. <br /> 555-23-003927-PRMT <br /> www.co:marion.or.us building@co.marion.or.us <br /> • Applicant: Bethel Excavating • • <br /> • <br /> PO Box 504 <br /> Turner, OR 97392 • • <br /> i Y s` ear I.,,,. ,1"XPI (:. t/ :t Y e, 11•4 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work:.MAJ REP: 3 BDRM SFD - <br /> g d � �� '� 'JOB SITE�IINFORMATICl 9 6 �u.T �� . , <br /> �� .�.. ,;�. t �,.,Rz;.E, n .:. c�av�oe�.� �... ,...�, ,;a �.., r,�aed., .. ,� � � ,e•Y^. .,�'� �r_a� <br /> Property Address: Parcel: Owner: CLAUSEN LT <br /> 8229 Jordan St Se,Salem,OR 97317 • 082W11A 00700-Primary <br /> Address: 8229 JORDAN ST SE <br /> SALEM OR 97317 <br /> 0 e"1„ _. 3 ° 'LICEN$ED PROFES. .:..SXO,Air N=CIM A ION <br /> dva...t�_ .....hH. <br /> Business Name License Address "Phone <br /> BETHEL EXCAVATING Installer 36198 PO BOX 504 TURNER OR 97392 (50-3)-743- <br /> License <br /> 4 t' d �`S t:,� "� c 407 rr mf <br /> v't^°�„ yw w�'=h., : ....`� w �' v <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 /> • <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 an:os/10/2023 1 std_BuildingApplication_pr <br />