HomeMy WebLinkAbout4816 Regency Dr - Permits - 04/29/1991DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION SITE SETBACKS
P.O. BOX 580, FORT COLLINS, CO 80522-0580 v
221-6769 REAR
BUILDING PERMIT
JOB SITE ADDRESS wL,16
F Permit Type Work Type Category Type _ LEFT RIGHT
dPr Use Zone Permt Level
Subdivision PUD Filing
PERMIT FEES
�J Subdivision/PUD
Building valuation
w
� FRONT
Lot Block Parcel No _ J - ACCOUNT FEE CRATE PAID
Last First 1. _ Lot Area
I±+ Address City --_—+ - LL.LrS P&( ti l w! _t, LQrj 7t Plat File No.
555E 16 r E ; Y SALS.S Us -,TA
Phone N O S[ate Zip o. Off St. Parking
Company Name Contractor License No.
O REQUIRED INSPECTIONS
Add
Tess
City
State
CALL 221-6769
TO SCHEDULE INSPECTIONS
Zip Phone Sales Tax No.
C)
(See reverse side for
U
Construction Type Occupancy Group Fire Sprinkler
Inspection Description)
Building Square Footage
No. of Stories
Bldg. Height
TOTALFEES
265.87
Occupant Load
Occupancy Separation
Area Separation
Fire Containment
O
3
No. of Dwelling Units
fro. of Bedrooms
Fireplace/Stoves
Basement
Stock Plan
Options
_ -
O
Z
a
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ZBA Case No. ^ BBA Case No
'Permit No _ ? v IPerr,a7,tD e. '� 7 7 _
As a con ition 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 i_q the event that issuance was based on incorrect information.
r
Signature Date 2� tf�
ORIGINAL - FILE. BLUE - OFFICE, CANARY - SALESTAX, PINK - APPLICANT. TAG - FIELD CARD
DEPARTMENTAL REVIEW
1ii •! t ��` e ° • SUB CONTRACTORS