HomeMy WebLinkAbout1724 Lake Sherwood Dr - Permits/Gas - Log, Line, Pipe - 11/18/1992DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769,
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dva a ms BUILDING PERMIT
JOB SITE ADDRESS
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Permit Tym
Work Type Category Type
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Proposed Use
Use Zone Permit Level
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Subdivision
PUD
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FilingPERMIT
FEES
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Subdivision/PUD
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FRONT
Lot
Bbck
Parcel No.
ACCOUNT
FEE
DATE PAID
Last
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M.I.
Lot Area
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BLDG, FERMIT FLAT
15. QU
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Address
City
Plat No No.
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1794
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State
Zip
Phone No.
Off St Parking
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Company Name
Contractor License No.
• •INSPECTIONS
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Address
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State
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CALL 221-6769
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TO SCHEDULE INSPECTIONS
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Phone
sales T.. No.
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Inspection Description)
Construction Type
Occupancy Group
Fire Spnnkler
GL
LG
Building Square Footage
No. of Stones
Bldg. Height
TOTAL FEES
1 AO
Occupant Load Occupancy Separation
Area Separation
Fire Containment
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Na of Dwelling Units No. of Betlrooms No. of Bathrooms Freplace/Stoves
Basement
Stock Plan Options
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GAS PIPE AND LOG SET INSTALLATION
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$15.00
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$15.00
ZBA Case No,
SEA Case No.
Permit Date
DEPARTMENTAL
DEPARTMENT
STATUS
DATE
Permit No,
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Elec cal
OTC PE
MIT ISS
As a condition for the issuance of a permit, I hereby declare that 1 am an owner
_
or the owner's agent, authorized to perform the proposed work on the property
described herein. 1 agree to comply with all the requirements contained herein,
Mechanical
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, This permit shall become null and void if the work authorized by
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such permit is not commenced, suspended, abandoned, or not inspected within
180 days from the data of such permit.
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Plumbing
Sgnature
Date
I ORIGINAL - FILE, BLUE - OFFICE, CANARY - SALESTAX, PINK - APPLICANT, TAG - FIELD CARD