HomeMy WebLinkAbout2826 Annelise Way - Permits/Sprinkler - 10/12/2006r� Community Planning &Environmental Services BUILDING PERMIT
Building & Inspections Division
l 3.
Bonding valuation
�= P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
CityofCity F phone (970) 221-6760 Fax (970) 224-6134
B0604742
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
2
' '."
Building Permit w/o Sus
i $15.
0 10/12J0
PERMIT
TYPE
PERMIT LEVEL
CATEGORY TYPE
SystemResidential Sprinkler
I City Sales/Use Tax
$3.
0 10/12/0
Last Name, First, id a nitial
onuction ype �
SR
Occupancy Group
cd
INC
County Sales/Use Tax
$0.
0 10/12/0
AddreS
City/State
p No. of Stories
Building Height
Z
O
0
Zip
Phone No. ' "
Building Square Footage
Stock Plan/Options
Front S a k
Rear Setback
Z_
Right Side Setback Left Side Setback
Z
2
• •
Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
SPK
_
Q
wLot
Block Lot Area Parcel No.
Name Contractor License So.
OCompany
U
I
„
Addresy' v i 1113,1ES, i a u City/State
ZZ
Phone on N n r vv Supervisor Cart. No.
V
Electric " License No.
rr
0
Mechanical
License No.
URoofing
License No.
r
Z
0
Framing
License No.
m
Plumbing
License No.
N
Concrete
License No.
SPRINKLER SYSTEM TO BE INSTALLED BY AUTUMN LANDSCAPING 3555 S SHERMAN ST #2 ,
ENGLEWOOD,CO 80113 303-794-6993 PROVIDE BACKFLOW DEVICE AND BACKFLOW TEST RESULTS TO BE
INSTALLED BY BACKFLOW TECH, 608 GARRISON ST #L, LAKEWOOD, CO 80215, 303-986-4601
w
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
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
commenced,
suspended, abandoned or inspected within 180 days from the date of such permit or from the date of the last inspection.
name of owner/agent Signature Date
TOTAL FEES
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