HomeMy WebLinkAbout4617 Regency Dr - Permits/Water Heater - 09/26/2000Community Planning &Environmental Services BUILDING P E RM I TPERMIT
FEES
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Building Valuation
$600_00
Fort CO 80522-0580
Collins, BOO 15819
Cityof
Fort Collins
Phone (970) 221-6760 Fax (970) 224-6134
ACCOUNT
FEE
DATE PAIN:,
JOB
SITE ADDRESS 4617 REGENCY DR FTCO
PERMIT DATE09/26/2000
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BuRding P•rmit WO/Subs
$15 00
09/26/200_
PERMITTYPE
Vii Water Heater
PERMIT LEVEL
ISSU_FUL
CATEGORY TYPE
RESIDENTIAL
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Last Name, First, Middle Initial
nstruction Type
Occupancy Group
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DORNSEIF, STEPHEN E
CoNo.
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Address
City / State
�''� of S[ories
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Building Height
3
4617 REGENCY DR
FORT COLLINS, CO
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Zip
80526.38f
Phone No.
228-042
Buildin g Square Footage Stock Plan/Options
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Front Setback
Rear Setback
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Right Side Setback
Left Side Setback
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Plat File No. ZBA Case Number
Zoning District
(See reverse side tor Inspection Description)
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Subdivlslon/PUD
Filing
FNP
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Lot Block Lot Area 0 Parcel M0310504$
Name Contractor License No.
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OCompany
Address
City/State
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OPhone
Supervisor Cert. No.
v
Electrical License No.
GMechanical
License No.
Roofing
License No.
0
Framing
License No.
Plumbing
License No.
N
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-
AMERICAN SERVICES, INC
MP-315
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REPLACE 50 GALLON ELECTRIC WATER HEATER
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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 City ordinances, and State laws associated with such work. I understand that such permit may be revoked in the
event
commenced,
that issuance was based on incorrect or incomplete information. This permit shall become null and void if the work authorized by such permit is not
suspended, abandoned or not inspected within 160 days from the da of s ch permit or from the date of the last inspection.
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Print
name of owner/agent Signature Date
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