HomeMy WebLinkAbout528 Skyline Dr - Permits - 04/29/1992QuAM
DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION SITE SETBACKS
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769 REAR
ttye BUILDING PERMIT
JOB SITE ADDRESS
Permit Type- Work Type Category Type - - - LEFT RIGHT
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SubdivisionEl PUD E Filing
PERMIT FEES
Q Subdivision/PUD Building Valuation
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Lot
Block
Parcel No.
ACCOUNT
FEE
DATE PAID
Last
First
M.I.
Lot Are:
Address
City
Plat File
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Stale
Zip
Phone No.
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Company Name
Contractor License No.
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City
State
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Zip
Phone
Sales Tax No. -
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ConstFuction Type
Occupancy Group
Fire Sprinkler
Building Square Footage
No. of Stories
Bldg. 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
No. of Bathrooms
Fireplace/Staves
Basement
Stock Plan
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Text:
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Permit No. Permit Date DEPARTMEIU C STATUS DATE
As a conditiono a isslFdnce of a permit, I hereby declare that I am an owner
or the owner' a nit, 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 pernyt 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, pujspended, abandoned, or not inspected within
18 ays from the date of s c
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Signatur ,,�,,'���yk�g•- Date
ORJGI)iAL - FILE, BLUE - OFFICE, CANARY - SALESTAX, PINK - APPLICANT, TAG - FIELD CARD
CALL 221-6769
TO SCHEDULE INSPECTIONS
(See reverse side for
Inspection Description)
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