HomeMy WebLinkAbout4164 Sumter Sq - Permits/Addition or Alteration - 10/25/1994DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769
REAR
rt�= BUILDING PERMIT
JOB SITE ADDRESS
LEFT RIGHT
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Permit T pe
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Pra osed Use
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Subdivision D, PUD
Filing .�
Subr ivi ior�PUD
Building Valuation
FRONT
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Lot
Block
Parcel No
ACCOUNT
FEE
DATE PAID
Last
First
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Lot Area _ --
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State
Zip _
Phone No.,
Off St. Parking
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Company Name
Contractor License No.
REQUIRED INSPECTIONS
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Address
City
State
CALL 221-6769
TO SCHEDULE INSPECTIONS
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(See reverse side for
zip
Phone
solos Tax No.
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Inspection Description)
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Construction Type
Occupancy Group
Fire Sprinkler
Building Square Footage
No. of Stories
Bldg. Height
TOTAL FEES
89. U 1
MOccupant
Load Occupancy Separation
Area Separation
Fire Containment
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ty
No. of Dwelling Units
No. of Bedrooms
No. of Bathrooms
Fireplace/Stoves
Basement
Stock Plan
Options
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to
ZBA Case No.
BBA Case No.
Permit No.
Permit-LlatafrBEG `S, 19C?4
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DEPARTMENT
STATUS
DATI'ECONTRACTORS
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01 Al I'`'tl E
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Electrical
As a conditi n for a issuance of a permit, I hereby declare that I am an owner
or the o is 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
Mechanical
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
such permit is not commenced, suspended, abandoned, or not inspected within
180 days from the at of ch permit.
Plumbing
Signatu
i
Dat/D
ORIGINAL I`LE, BLUE - OFFICE, CANARY - SALESTAX, PINK - APPLICANT, TAG - FIELD BARD