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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> HarlonSalem,OR 97305 <br /> County 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> ORE O ON <br /> 555-23-008453-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Mike Hamer, Inc. <br /> 32948 Brewster Road <br /> Lebanon, OR 97355 <br /> 4-1, h. 1 s, ;; ,v a.._.n �� a<.fix � <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 SFD <br /> ? w'w ,� ' 'tea -. ,:x ti n@® `i-_ h 4 - <br /> ''t- to.,, ,.¢,a . .i:i3Sr1T �I'Ni RM` T f tY4., .: ?A <br /> Property Address: Parcel: Owner: HITZ,ARTHUR R <br /> 17245 Wall Ln Se,Jefferson,OR 97352 103W13AA01500-Primary <br /> Address: 17245 WALL LN <br /> a 9 w ', c k JEFFERSON 97352 <br /> .. s . I:ICEN51*D!�Pq OFFS tiitAl <INF01folATIONi* , ' 4 $` <br /> Business Name License Address Phone <br /> MIKE HAMER,INC. Installer 37908 32948 BREWSTER ROAD LEBANON OR 541-928-5074 <br /> License 97355 <br /> 11,4 <br /> Fee Description Quantity Amount <br /> Repair(major)-single family dwelling 1.00 Ea $640.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $740.00 <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/O6/2023 1 std_BuildingApplication.pr <br />