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�.., <br /> MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> -�-. --T, Salem,OR 97305 <br /> arion <br /> 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <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 /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Accessory Structure $0.00 <br /> Description of Work: MA]ALT: ADD PUMP TANK FOR ACCR <br /> •w ! iota iV,TE INFORMAtiotI t „ <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 /> • LICENSED PROFESSIONAL INFORMA'iION ' ... `__,_A <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Alteration (major) 1.00 Ea $745.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $845.00 <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/zi/zozs 1 std_BuildingApplication_pr <br />