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= MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion <br /> Salem,OR 97305 <br /> GOu 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGO.N <br /> 555-23-000912-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: TRACHY, DAVID L&TRACHY, PENNY R <br /> 4394 71ST AVE SE <br /> SALEM, OR 97317 <br /> i�* 1a�� �� 0s�.��i`��•� � '�s s per+/� �`x�u i �c��� ��r�� .� <br /> .: , f1 { "° ...,..,.m,. ... ..........TYR'L"s�t7 04R �/, . 9&5, ,�� oBa y' ry„? ,2 y �c i•P „w,fua u ...,.s <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Accessory Structure $0.00 <br /> Description of Work: MIN ALT: ADD PUMP TANK FOR ACCR <br /> joB#jt,; -'00RMAT*:iht .> oz b ;itrMOA , . <br /> Property Address: Parcel: Owner: TRACHY, DAVID L&TRACHY, <br /> 4394 71St Ave Se,Salem,OR 97317 082W10D 01300-Primary PENNY R <br /> Address: 4394 71ST AVE SE <br /> SALEM OR 97317 <br /> LIGIR[ RCI!~ESuQN/lt.IIUFATQN <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Alteration (minor) 1.00 Ea $415.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $515.00 <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:oz/o1/zaz3 1 std_BuildingApplication pr <br />