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17232 MEADOWDALE BEACH RD.pdf
r. lw { y , APPLICATI(_ V A WORK PERMIT �_ Applicati¢n No. �/•� .•� 3 p f CITY OF EDMOND5 Building Department Permit Limit, one year 4 APPLICATION is hereby made for a permit to construct the following work, in accordance with the accompanying plana and specifications:' WORK — New/Addn...0 r� - ••. ........ .................................................... Ground Area.................................... No. Start as ..... 1.... ' Plana Submitted ....... ...y � Const. Type:._ ......................................... ... Height. �i LOCATION.- Address ..._l..lr.�.�..rZ..-..e� LiLe!�euQa� ._..... �%C�Vse Zone ' ... ..._ ._ . re Zone . Recorded I,ot ...»..»... Block .................... Add'nULL �°..GL fLGr Sew¢rage..FKJ��-1 { Lot Area 's .L.-pt!!;n�..±'Width.L�5.�............. Min. Bldg. Setbacks, Front and Rmc;,Zd'»' 2`:........... Siaes..7.171. :..:.:.... ' ....................._.......... Addr�e..✓..©1-1^y1"v.......... e.. -Owner Phon t Plans by. .._...-......>zC% »........... Address ............ - ....... Phone........ ... .: Bldg. by...» . ...._......j».................................................... Address ...... ..................... ...._...............» - ......... Phone............................'i ' s i ......._ .... Phone ....... Plbg. byAddress..._......... ......... t Heatb* by ....... .................................. Address ....... ........ ............... .... .... Phone........ Elect. by.: _... ...... ...................................................... Address ..._.......... .... ....... ....................... ......... Phone ..:.... ... ... _... Remarks ........»..».....» .......................... .................................................. _................................... ....................... ............._.. ... ........ i � a ........._..».................................................. _............... ........ _.......................................................................... ..... The above is a co�asat-etret -and-I-a to omply with all applicable Codes and State Laws regulating the work. •:' Signed: Owner/Agtin ........ .. ...�..... Address. ....................................... r PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plane and specifications and Building Department notations thereon. } VALUATION PERMIT FEES j J $....�...1,w...�,,......,,r .Bldg. ....$:.�..,.(}�...... j APPROVED: //�J ••��,, Heat .... S ..._..,�„ .. ..................... ' ! Date...................!/... ............. .............. Elect. .... .................................... BUILDING DEPARTMENT Others ... $........................................ %m Herber: n..a�.l pi .......�........ TOTAL FEE $..�.1. ... .C...'...._ , NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval. t Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as curbs, paving, driveways, sewer, water and street connections. l f