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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Salem,OR 97305 <br /> Platiort <br /> County Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-21-002265-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: 3A Construction, LLC <br /> 1690 Harvey St SE <br /> Jefferson, OR 97352 <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- MA] REP: 1 BDRM SFD <br /> oB SI'll" INFO • ' <br /> Property Address: Parcel: Owner: WILSON FAM TR <br /> 22636 Jennie Rd Se, Lyons,OR 97358 092E18DB00100 - Primary <br /> Address: PO BOX 99 <br /> LYONS OR 97358 <br /> z yy € LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> 3A CONSTRUCTION,LLC Installer 39002 1690 HARVEY ST SE JEFFERSON OR 97352 (97-1)-218- <br /> License <br /> MrxePERMIT FEES Jr <br /> Fee Description Quantity Amount <br /> Repair(major)- single family dwelling 1.00 Ea $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $700.00 <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 03/05/2021 i std_BuildingApplication_pr <br />