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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 /> O R;E..G:O;N' <br /> 555-23-008352-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Owen Construction, Inc. <br /> P.O. Box 21150 <br /> Keizer, OR 97307 <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: 3 BDRM SFD `°+ g t%�. i, dk� M 8 <br /> a, v <br /> Property Address: Parcel: Owner: BARNWELL JRLT <br /> 330 Janice Ct, Detroit,OR 97342 105E02DA06400-Primary <br /> Address: 2069 LIMESTONE AVE SE <br /> SALEM OR 97306 <br /> Q ,w � CI NS PE O SAC NI C IN a A m e �fi' � <br /> Business Name License Address Phone <br /> OWEN CONSTRUCTION,INC. Installer 38534 P.O.BOX 21150 KEIZER OR 97307 503-390-6936 <br /> '10License <br /> ,. r .;;;,,, <br /> Fee Description Quantity Amount <br /> Install-ATT-by gallons per day 450.00 GPD _ $1,440.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,540.00 <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:10/04/2023 1 std_BuildingApplication_pr <br />