HomeMy WebLinkAbout3126 Chase Dr - Permits/Sprinkler - 10/12/2006_ Community Planning &Environmental Services BUILDING PERMITPERMIT
FEES
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Building Valuation
logo" Fort Collins, CO 80522-0580
CityofFodCollins phone (970) 221-6760 Fax (970) 224-6134
80604753
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
"'
Building Pernit w/o Sub
$15.
0 10/12/0
PERMIT
TYPE
PERMIT LEVEL
_
CATEGORY TYPE
tq
I City Sales/Use Tax
$3.
0 10/12/0
Last Name, First, Middle Initial
ConZruction Type
Occupancy Group
County Sales/Use Tax
$0.
0 10/12/0
Address
City/State
p No. of Stories
Building Height
Z
3AI-IRi
COO
V
Zip
Phone No.
Building Square Footage
Stack Plan/Options
301-466-1381
Front Setback
Rear Setback
REQUIRED INSPECTIONS
Right Side Setback
Left Side Setback
Z
CALL 221-6769
Z
TO SCHEDULE INSPECTIONS
(See reverse side for Inspection Description),
S P K
Plat File No. ZBA case Number
Subdivision/i
Zoning District
Filing
_
Q
wLot
Block Lot Area Parcel No.
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9n
Name Contractor License No.
OCompany
V
Address City/State
H
Z
0
Phone Supervisor Cert. No.
Electrical License No.
rr
Mechanical
License No.
Roofing
License No.
H
Z
Framing
License No.
0
m
Plumbing
License No.
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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