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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Narion Salem,OR 97305 <br /> county Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-21-000222-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: ROLEY,KENNETH L <br /> 3075 BRIDLEWOOD WY S <br /> SALEM, OR 97306 <br /> TYPE OF WORIM111111111111111111111111111111 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: MAJ REP: 3 BDRM REPLACING 3 BDRM <br /> JOB SITE INFORMATION <br /> Property Address: Parcel: Owner: ROLEY,KENNETH L <br /> 25295 Santiam Park Rd Se, Lyons,OR 97358 092E22C 00800 - Primary <br /> Address: 3075 BRIDLEWOOD WY S <br /> SALEM OR 97306 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> SEE PROPERTY OWNER INFORMATION Owner OWNER <br /> (Property) <br /> PERMIT FEES I <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 /> (2J <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:01/08/2021 i std_BuildingApplication_pr <br />