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MARION COUNTY <br /> Building Application 5155Silverton Rd NE <br /> Marlon Salem,OR 97305 <br /> County Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> O•.R E G O N <br /> 555-21-004692-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: MUELLER,JACOB <br /> 10575 KAUFMAN RD NE. APT 6 <br /> SILVERTON, OR 97381 <br /> .., TYPE*WORK. . . ... . �,s �. <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: MA]ALT: 4 BDRM SFD TO REPL 2 BDRM SFD <br /> r; Og SITE INFORMATI 1,. <br /> Property Address: Parcel: Owner: GEM FARMS LLC <br /> 6336 55Th Ave Ne,Salem,OR 97305 062W33B 00400-Primary <br /> Address: 6576 55TH AVE NE <br /> SALEM OR 97305 <br /> INFORMATION a ..,, .f g, <br /> Business Name License Address Phone <br /> PF»RMI FEES m 01 t r a <br /> Fee Description Quantity Amount <br /> Alteration(major) 1.00 Ea $675.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $775.00 <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:05/05/2021 1 std_BuildingApplication_pr <br />