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HomeMy WebLinkAbout630 Brewer Dr - Permits/Gas - Log, Line, Pipe - 12/04/2000Planning Environmental ServicesPERMIT BUILDING P E RM I T FEES Building & Inspections Division dhCommunity P.O. Box 580 281 N. College Ave. Building valuation Fort Collins, CO 2-050 2 7 7 0 0 Phone (970) 221-6 60 Fax (970) 224-61;34 B00 3 1 $ r ACCOUNT FEE DATE PAID: JOB SITE ADDRESS 630 BREWER DR PERMIT DATE 12/04/2000 Building Perait w/o Subs $15.00 12/4/00 , PERMIT TYPE GASLOG Gas Log — Gas L i ght.er PERMIT LEVEL ISSO._FUL CATEGORY TYPE RESIDENTIAL Last Name, First, Middle Initial EASOII, BEORGE ANTHONY Construction Type Occupancy Group W. Address 630 BREWER DR city / St a ?ORT COLLINS, CO No. of Stories Building Height Z o 3 O V Zip 80524 Phone No. 407-7269 Building Square Footage 0 Stock Plan/Options 1 Front Setback Rear Setback REQUIRED' Z Right Side Setback Left Side Setback Z TO SCHEDULE INSPECTIONS Plat File No. ZBA Case Number Zoning District (See reverse si a or Inspection Description) Subdivision/PLID Filing GL LG Q w ' Lot Block Lot Area Parcel N}ti. 0 9701132031 Co71T P ICE WEST II, INC Contractor License To-13H1 Addy4 N COLLEGE AVE Doti COLLINS, CO 80524 Zo PhoT10-498-9679 Supervisor Cert. No. Electrical License No. 04 OMechanical License No. Roofing License No. Z 0 Framing License No. on Plumbing License No. v=i INSTALL GAS FIREPLACE, GASLINE AND STOVE 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. 1 agree to comply with all City ordinances, and State laws associated with such work. I understand that such permit may be revoked in the a event ll become null and void the work authorized by such permit is not that issuance was based on Incorrect or incomplete information. This permit shall a + .,> commenced, suspended, abandoned or not inspected within 180 days from the date of such permit or from the date of the last inspection. J , *i ': .. 8 of own ��/ —Signature e`�'�r`"`oy�� 1, Date n7ame