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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion _ Salem,OR 97305 <br /> County Authorization NA FAX:FAX: 503-588-7948 <br /> OREGON <br /> 555-21-005331-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: TURECK,SHANNON M <br /> 33693 RAILROAD AV SE <br /> GATES, OR 97346 <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:AUTH. 3 BDRM SFD TO REPLACE 3 BDRM <br /> h 30B'SITE INFORMATION F ' <br /> Property Address: Parcel: Owner: TURECK,SHANNON M <br /> 33693 Railroad Ave Se, Gates,OR 97346 093E25DCO2500- Primary <br /> Address: 33693 RAILROAD AV SE <br /> GATES OR 97346 <br /> LICENSE©PROFESSIONAL;INFORMATION u t : .. z e ;, ... F <br /> Business Name License Address Phone <br /> .P,ERMIT,_FEES ., e <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $450.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $550.00 <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 on:05/20/2021 1 std_BuildingApplication.pr <br />