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Building Application MARION COUNTY <br /> 5155 sllverton Rd NE <br /> lTlack,, Salem,OR 97305 <br /> county Residential Septic - DEQ 503-588-5147 <br /> FAX 503-588-7998 <br /> OREGON <br /> 555-15-007824-SEP <br /> www.co.marion.or.us building@co.marion.or.us <br /> ********** PERMIT HAS NOT BEEN ISSUED ********** <br /> Tvoe of Work: Catenary of Construction: <br /> New Installation Single Family Dwelling <br /> Description of Work• NEW INSTALL: 4 BDRM SFD p <br /> ksi . >s:, i S$9 u_ ,: JOB SITE,T,�/.'..a.a- ' 03t .aa,.. <br /> Property Address: Parcel: Owner: ANOERSON,MARK I <br /> 21579 Champoeg Creek Ln Ne, St Paul,OR 042W12 01300-Primary <br /> 97137 Address: 21579 CHAMPOEG CREEK LN <br /> NE <br /> { ST PAUL OR 97137 <br /> 4ein .... .. . OFESSiON yI . t.!lf , CK.._•.' ...uv4' <br /> Business Name I'cense Address Pbone <br /> NEW UNE CONSTRUCTION INC. Installer 37465 6317 NICKLAUS LOOP N. KEISER OR 97303 (50-3)-390- <br /> qi :Al :01":.+4:4447):!.Lice G . ' 21•••••••••"•• • _]. <br /> The list of inspections below represents the inspections required for this project at the time of permit printing. Additional inspections may he <br /> required through the life of the project. You will receive notification of any additional inspection requirements for project completion. All <br /> required inspections must be completed and approved. <br /> Schedule Inspections online at www.bu'ildingpermits.oregon.gov or by calling: 1-888-299-2821 <br /> When calling for an inspection, use IVR Number: <br /> q4 _ .. �.,� . . .,., r .._1. <br /> ik4 <br /> .a e . ...:.-1k �em,. �'�7 r .. pa'�'f`. FEE�„" fi�4,Y. ' <br /> Fee Description Ouantity Amount <br /> Install-Standard system 1.00 Ea $750.00 <br /> DEQ surcharge 1.00 Ea $100.00 <br /> Total Fees: $850.00 <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. Granting of a permit does not presume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. <br /> All persons or entities performing work under this application are required to be licensed <br /> unless exempted by ORS 701.010. <br /> 1 <br /> Printed on:11/23/2015 <br />