HomeMy WebLinkAbout640 S Shields St - Permits - 08/07/1992DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
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P.O. BOX 580, FORT COLLINS, CO 80522-0580
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221-6769
4
REAR
city of BUILDING PERMIT
LEFT RIGHT
JOB SITE ADDRESS
'1—
Permit Type
Work Type Category Type
p¢
Proposed Use
Use Zone Permit Level
Subdivision PUD
Filing
PERMIT FEES
Building Valuation
4
Subdivision(PUO
425
FRONT
Lot
Block
Parcel No.
ACCOUNT
FEE
DATE PAID
Last
First
M.I.
Lot Area
MTN & PLAINS
I I
BLDG PERMIT FLAT
15.00
W
CITY SALES USE TA
0.00
Address
City
Plat File No.
3
18 CANYON AVE
FORT COLLINS
State
Zip
Phone No.
Off St. Parking
O
Company Name
I Contractor License No.
REQUIRED INSPECTIONS
FAGI-O
Address
City
State
CALL 221-6769
Y
I FT COLLINS
CO
TO SCHEDULE INSPECTIONS
o
Zip Phone
Sales Tax No.
(See reverse side for
Inspection Description)
'Construction Type
Occupancy Group
Fire Sprinkler
FNP
Building Square Footage
No. of Stories
Bldg. Height
TOTAL FEES
15.00
Occupant Load
Occupancy Separation
Area Separation
Fire Containment
3
u_
No. of Dwelling Units
No. of Bedrooms
No, of Bathrooms
Fireplace/Stoves
Basemen[
Stock Plan
Options
O
OText,
d
WATER HEATER REPLACEMENT
N
7I&MM"IT
H 21
°
7H21
15.00H
15.00
15.00
ZBA Case No.
BBA Case No.
Permit Date
•
QEPAiiTMENT
DA.I.
Permit No.
•
•
09 20 4
A ST 7 1992
-STATUS
OTC PE
Electrical
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 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 date of such permit.
,A,
Plumbing
Signature ' / n
Date _ � i
ORIGINAL - FILE, BLUE - OFFY, CANARY - SALESTAX, PINK - APPLICANT, TAG - FIELD CARD