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MARION COUNTY <br /> • Building Application 5155 Silverton Rd NE <br /> •"Marion Salem,OR 97305 <br /> County Authorization TVA503-588-5147 <br /> FAX: 503-588-7948 <br /> O R.E'G O.N <br /> 555-23-004087-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Clinton Construction, Inc <br /> PO Box 128 <br /> Scio, OR 97374 <br /> ,TY� O wowzK., <br /> • <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Manufactured Dwelling $0.00 <br /> Description of Work: FIRE: 2 BDRM MH TO REPL BURNT 2 BDRM MH <br /> Property Address: Parcel: Owner: 715 NW RIVER ROAD LLC <br /> 100 E Central Ave,Gates,OR 97346 093E26CCO2600- Primary <br /> Address: PO BOX 580 <br /> MILL CITY OR 97360 <br /> ..., .. y` �w LICENSED,PROFESS .,®,NAL,INFORMATION, �r ,: 5 � <br /> Business Name License Address Phone <br /> CLINTON CONSTRUCTION,INC Installer 39098 PO BOX 128 SCIO OR 97374 (50-3)-871- <br /> License <br /> a .,a .. :' .., .".....PERMIT"FEES .,,.M '. . <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $605.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $705.00 <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:06/05/2023 1 std_BuildingApplication_pr <br />