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ua�^o a MARION COUNTY <br /> Building Application <br /> 5155 Silverton Rd NE <br /> Marion- Salem,OR 97305 <br /> ,Courzty Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OR-EGON <br /> 555-21-004633-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Action Drain &Rooter Service <br /> 3690 Kashmir Way. SE <br /> Salem, OR 97317 <br /> TYPE QE WORK <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Manufactured Dwelling $0.00 <br /> Description of Work: AUTH MA]ALT: 4 BDRM MH <br /> , <br /> Property Address: Parcel: Owner: ]UAREZ,MARINO VASQUEZ <br /> 9929 Crosby Rd Ne,Woodbum, OR 97071 051W06B 01100- Primary <br /> Address: 856 BLAINE ST <br /> WOODBURN OR 97071 <br /> tCENSD PRQFESSf�NAL INF�RMATIN ,,�. <br /> Business Name License Address Phone <br /> ACTION DRAIN&ROOTER SERVICE Installer 36323 3690 KASHMIR WAY,SE SALEM OR 97317 (50-3)-370- <br /> License <br /> Fee Description Quantity Amount <br /> Alteration(major) 1.00 Ea $675.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $775.00 <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:05/04/2021 1 std_BuildingApplication pr <br />