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MARION COUNTY <br /> Building Application 515s silverton Rd NE <br /> MarionSalem,OR 97305 <br /> County 503-588-5147 <br /> Authorization NA FAX: 503-588-7948 <br /> Q,RE Cs 0,1 <br /> 555-23-006472-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: BURTON, DEAN &ANN <br /> 9434 N WOOLSEY <br /> PORTLAND, OR 97203 <br /> ,' , s 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: AUTH TO REPL 2BD DWL W/2BD MD <br /> Istry,r144; R >,. _ r . <br /> Property Address: Parcel: Owner: BURTON, DEAN&ANN <br /> 22832 River Rd Ne,St Paul,OR 97137 042W04 01200-Primary <br /> Address: 9434 N WOOLSEY <br /> LICEN�.t 1C ICE PORTLAND OR 97203 <br /> r :°?i4 ' x. :,: SE,€PR , kOI�F`t� � �� . ON � a <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $650.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $750.00 <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:07/28/2023 1 std_BuildingApplication_pr <br />