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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> at7D/z .. Salem,OR 97305 <br /> 503-588-5147 <br /> County Permit NA FAX: 503-588-7948 <br /> O'R.E G O.N <br /> 555-21-007762-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: GREEN, BRAD <br /> 2009 NE BRAZEE <br /> PORTLAND, OR 97212 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: FIRE- MA] REP <br /> A �r�, ,� OB SITE X RMlkT1iiN .�,.. <.,a�,w,..,,, ra ..,Xv.9 'M.fix.,gL. mow_ ra, a.�. k°' ..F ,...,,., .., <br /> Property Address: Parcel: Owner: ELKHORN CORP <br /> 34897 North Fork Rd, Lyons,OR 97358 084E31 00100-Primary <br /> Address: 2009 NE BRAZEE <br /> PORTLAND OR 97212 <br /> Business Name License Address Phone <br /> !hERM, <br /> x a <br /> Fee Description Quantity Amount <br /> Repair(major)-single family dwelling 1.00 Ea $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $700.00 <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 701.01.0. <br /> Printed on:07/30/2021 i std_BuildingApplication pr <br />