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MARION COUNTY <br /> • Building Application 5155 Silverton Rd NE <br /> Marian. Salem,OR 97305 <br /> county 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> ORE'G'O,N <br /> 555-23-005626-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Ken Tooze Excavation, Inc <br /> 8624 Blackhawk Ct SE <br /> Salem, OR 97317 <br /> a'a5TTittS4 P�a b�NAM S a k .� �-0 <br /> e <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: MAJ REP: CHRUCH 250 SEATS <br /> f a :.. * F„ t'J B)STE1S1FiJE2M4TQtL�t ,... ,,. 6� .., ' <br /> Property Address: Parcel: Owner: OREGON CONFERENCE <br /> 5575 Fruitland Rd Ne,Salem,OR 97317 072W21CC03300- Primary Address: C/O EAST SALEM 7TH DAY <br /> ADVENTIST <br /> GLADSTONE OR 97027 <br /> ea.n k r a z >- m,n s ? as <br /> u rasa. .tta ¢ ...£ ,LIGENSI:U PRt31E=N SS C# AL 17,FOR Attu. <br /> Business Name License Address Phone <br /> KEN TOOZE EXCAVATION,INC Installer 39231 8624 BLACKHAWK CT SE SALEM OR 97317 503-390-0510 <br /> License <br /> Fee Description Quantity Amount <br /> Commercial facility plan review-by gallons per day 1,250.00 GPD $370.00 <br /> Repair(major) -commercial facility 1,250.00 GPD $690.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,160.00 <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:06/30/2023 1 std_BuildingApplication pr <br />