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, MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> County 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> ORE G O N <br /> 555-22-000881-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: WELLS, LARRY WAYNE &WELLS, KAREN L <br /> 3080 JEFFERSON-SCIO DR SE <br /> JEFFERSON, OR 97352 <br /> TYPE OF WORK <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 2 BDRM SFD <br /> JOB SITE INFORMATION <br /> Property Address: Parcel: Owner: WELLS, LARRY WAYNE& <br /> 3090 Jefferson Scio Dr Se,Jefferson, OR 97352 103W13 00500 - Primary WELLS, KAREN L <br /> Address: 3080 JEFFERSON-SCIO DR <br /> SE <br /> JEFFERSON OR 97352 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> ATCHLEY LOGGING&CONSTRUCTION, Installer 391/4 PO BOX 129 LEBANON OR 97355 (54-1)-979- <br /> INC License <br /> PERMIT FEES ..- . <br /> Fee Description Quantity Amount <br /> Install - Pressurized distribution- by gallons per day 450.00 GPD $990.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,090.00 <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:01/31/2022 1 std_BuildingApplication_pr <br />