HomeMy WebLinkAbout1685 Kirkwood Ct - Permits/Gas - Log, Line, Pipe - 11/22/1991DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-676
tVo o BUILDING PERMIT
JOB SITE ADDRESS
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Permit Type j�
Work Type
Category Type
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Proposed Usa
Use Zone
Permit Level
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FilingPERMIT
FEES
Subdivision PUD
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@SAding Valuation
Subdivison/PUD
Lot
Block
Parcel No.
ACCOUNT
FEE
DATE PAID
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Phone No.
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Company Name i
contractor License N.
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Address
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city-
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Phone
Sales Tax No.
Construction Type
Occupancy Group
Fire Sprinkler I
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Building Square Footage
No. of Stones
Bltlg. Height,
TOTAL FEES
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Occupant Load
Occupancy Separation
Area Separation
Fire Containment
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No. of Dwelling Units
No. of Bedrooms
Fireplace/Stoves
Basement
Stock Plan
Options
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OText:
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As a condition for the issuance of a permit, I hereby declare that I am
an owner or the owner's agent, authorized to perform the proposed
work on the property described herein. I agree to comply with all the
requirements contained herein, and City ordinances, and State laws
associated with such work. I understand that such permit may be
revoked in the event that issuance was based on incorrect information.
DEPARTMENT
LEFT
No.
REAR
FRONT
RIGHT
TO SCHEDULE INSPECTIONS
(See reverse side for
Inspection Description)
—ENM_
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