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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> aria Z- Salem,OR 97305 <br /> county <br /> Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> O::RECON <br /> 555-20-007133-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Action Drain &Rooter Service <br /> 3690 Kashmir Way. SE <br /> Salem, OR 97317 �f! <br /> 240 t k- '''a _ •.; 2g. 32 xfti .« <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 FOR SHOP, BATH &KITCHENETTE <br /> JOB SITE,TN e RMATIOI ` A <br /> Property Address: Parcel: Owner: DELANGE,KREGG L <br /> 8383 Redstone Ave Se,Salem,OR 97306 083W33A 00800- Primary <br /> Address: 8383 REDSTONE AV SE <br /> SALEM OR 97306 <br /> n . .x_ :L:tCENS D PROFESS ONAI NI FORMATION ; q912. <br /> Business Name License Address Phone <br /> ACTION DRAIN&ROOTER SERVICE Installer 36323 3690 KASHMIR WAY,SE SALEM OR 97317 (50-3)-370- <br /> License <br /> .:+..s ' a- sr�a' - 9 • gar - `� �" <br /> ' •a- E 9 tY 3* - z IGJ <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:10/07/2020 1 std_BuildingApplication pr <br />