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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-23-008850-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: KAUFMAN HOMES INC <br /> 5797 STATE ST <br /> SALEM, OR 97317 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: SE: 4 BDRM SFD <br /> Property Address: Parcel: Owner: DOUBLE K PROPERTIES LLC <br /> 2851 Forest Haven Way S, Salem, OR 97302 TEMP MC-Primary <br /> Address: 5797 STATE ST <br /> SALEM OR 97317 <br /> tOr $4,4 ... - r, ,. xM.� z�arard:e. m �, .>., ...rtss k. 3» • .�,• <br /> ,N <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Site evaluation -Single family dwelling 1.00 Ea $810.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $910.00 <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: 10/20/2023 1 std_BuildingApplication pr <br />