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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarkinSalem,OR 97305 <br /> County Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> Q,.R;E G O wN <br /> 555-23-005874-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: ALVAREZ, VINCENTE A <br /> 1850 CHEMAWA RD N <br /> KEIZER, OR 97303 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: MAJ ALT TO MAOVE ENTIRE SYSTEM 4 BDRM SFD L `, <br /> .�° �..,"i `�' ,..da, � �✓ n rs OB SITE A ��FORMA ON- � a6 ,,,, u'�` r'3-i ce.$: .., <br /> Property Address: Parcel: Owner: ALVAREZ,VINCENTE A <br /> 1850 Chemawa Rd N, Keizer,OR 97303 073W04 00800-Primary <br /> Address: 1850 CHEMAWA RD N <br /> 7,11% �} I�.�+ �+�ttC1E7 �t KEIZER OR 97303 <br /> <.. t ` °�:°- .. « €r'a - FPS PR FE � " INFORMAF.M- Li F ,» v` ', �p.. 12 :s . t <br /> Business Name License Address Phone <br /> 00:th;' x r' s g ° OPr >% ae` , <br /> Fee Description Quantity Amount <br /> Alteration (major) 1.00 Ea $800.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $900.00 n {;;. <br /> Note:This may not include all the fees required for this project. "I <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:07/11/2023 1 std_BuildingApplication_pr <br />