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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Man'on <br /> Salem,OR 97305 <br /> County E'K <br /> !;. j 503-588-5147 <br /> Permit NA ..� r F X: 503-588-7948 <br /> OREGON <br /> 555-21-002713-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: ANFILOFIEFF,IVAN <br /> PO BOX 448 <br /> HUBBARD, OR 97032 <br /> T°W5. TYPE of WORK <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 TANK TO PERSONAL SHOP/2 OFFICES/ KITCHENETTE <br /> � ..._. ,JOB SITE INFORMATION, <br /> Property Address: Parcel: Owner: ANFILOFIEFF,IVAN <br /> 12244 Dimmick Ln Ne, Woodburn, OR 97071 051W04 02300- Primary <br /> Address: PO BOX 448 <br /> HUBBARD OR 97032 <br /> LICENSED PROFESSIONAL INFORMATIONm <br /> Business Name License Address Phone <br /> SEE PROPERTY OWNER INFORMATION Owner OWNER <br /> (Property) <br /> PERMIT FEES <br /> Fee Description Quantity Amount <br /> Alteration (minor) 1.00 Ea $175.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $275.00 <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:03/16/2021 i std_BuildingApplication_pr <br />