HomeMy WebLinkAbout1715 W Mountain Ave - Permits/Addition or Alteration - 10/14/2005Community Planning &Environmental Services BUILDING PERMITPERMIT
Building & Inspections Division
FEES
P.O. Box 580 281 N. College Ave.
Building Valuation
Fort Collins, CO 80522-0580F
CiiyofFortCollins phone (970) 221-6760 Fax (970) 224-6134 B0505684
$30,000.00
ACCOUNT '
FEE
DATE ! PAID:
JOB
SITE ADDRESS 1715 W MOUNTAIN AVE
PERMIT DATE 10 / 14 / 200 5
Plan Check Fee
Building Pemit u/ Su6¢
$125.4
$260.5
i 9/29/05
i 10/14/05
PERMIT
TYPE
CIMALAD Com/Ind/MixedAlt/Addition
PERMIT LEVEL
ISSU_FUL
CATEGORY
SatePEllite Dish/Telecomm
Last Name, First, Middle Initial
CITY OF FORT COLLINS
Construction Type
Occupancy Group
I
W
w
ty
U-2
Address
PO BOX 580
City/State
ry FORT COLLINS, CO
O No. of Stories
V
Building Height
Zip 80522
Phone No.
O
Building Square Footage Stock Plan/Options
1
Front Setback
Rear Setback
•
Z
Right Side Setback
Left Side Setback
• •
,
Plat File No. ZBA Case Number
Subdivision/PUD
Zoning District
ppL
Filing
(See reverse side for Inspection Description)
S B F RP R M
J
wLot
F N E F N P F N M
U C E F D H 0 O
Block Lot Area a Parcel No. 9710316901
Name Contractor License No.
OCompany
Address
P S W R
City/State
WTI U R AW
HAN RE Eu
Phone Supervisor Gert. No.
V
Electrical License No.
ALPINE ELECTRIC, INC ME 948
Mechanical
License No.
fff0-
Roofing
License No.
0
Framing
License No.
Plumbing
License No.
to
Concrete
License No.
INSTALL SIX CRMS CELL ANTENNAS AND THREE EQUIPMENT CABINETS (INCLUDING BATTERIES) ON
EXISTING LIGHT POLE
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 k Date
Print
TOTAL FEES