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,N MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> COutztf 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> O RE G O N <br /> 555-22-007282-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Owen Construction, Inc. <br /> P.O. Box 21150 <br /> Keizer, OR 97307 <br /> +. 3 ORksa.. xj3i <br /> _.._ <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: NEW INSTALL: 3 BDRM SFD <br /> Property Address: Parcel: Owner: C M BRAVO TR <br /> 6015 Barcelona Dr Se,Salem,OR 97317 082W20A 00400-Primary <br /> Address: 1161 WILTSEY RD SE <br /> • <br /> SALEM OR 97306 <br /> .--- LIC NSITD PRQI=ESS ONAL-TN Q tI ATIQ( _., � a <br /> Business Name License Address Phone <br /> OWEN CONSTRUCTION,INC. Installer 38534 P.O.BOX 21150 KEIZER OR 97307 (50-3)-390- <br /> License <br /> :* _".4 ;_.,�.�� �PERMIT p1=FS_.�.�.�. �,.._ �41..�; <br /> Fee Description Quantity Amount <br /> Install-ATT-by gallons per day 1.00 GPD $1,320.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,420.00 <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:08/12/2022 1 std_BuildingApplication_pr <br />