HomeMy WebLinkAbout5127 Stillwater Creek Dr - Permits/Mechanical - 11/29/2006Community Planning & Environmental Services BUILDING P E RM I TPERMIT FEES
Building & Inspections Division
�- P.O. Box 580 281 N. College Ave. Building Valuation
Fort Collins, CO 80522-0580
City ofF� phone (970) 221-6760 Fax (970) 224-6134 EBa6055l1 1
ACCOUNT FEE + DATE PAID
JOB SITE ADDRESS PERMIT DATE
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PERMIT TVPF ..�.,..�r , �..�� .. Building ( y � J . U U i
Last Name, First, Middle Initial
Construction Type
Occupancy Group
Z
Z
Address
City/State
p No. of Stories
Building Height
O
Zip
Phone No.
Building Square Footage Stock Plan/Options
Front Setback
Rear Setback
Z
Right Side Setback Left Side Setback
Z
Plat File No.
•
ZBA Case Number Zoning District
(See reverse side for Inspection Descri
GL FNM
Subdivision/PUD
Filing
Q
wLot
J
Block Lot Area
Parcel No.
C
I Company Name
Contractor License No.
City/State
tieancal
License No.
Mechanical
License No.
GRoofing
License No.
H
Z
Framing
License No.
8
Plumbing
License No.
N
8
H
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.
Print name of
Signature
TOTAL FEES