HomeMy WebLinkAbout3310 Moore Ln - Permits/Water Heater - 03/02/2006Community Planning &Environmental Services
FEES
Building & Inspections Division BUILDING PERMITPERMIT
P.O. Box 580 281 N. College Ave.
Building Valuation
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 60600878
ACCOUNT
FEE 11
GATE PAID'
JOB
SITE ADDRESS
PERMIT DATE
70 OORELN
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Building
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PERMIT
TYPE
PERMIT LEVEL CATEGORY TYPE
Water Heater ISSt! FUL Residents
Last Name, First, Middle Initial Construction Type Occupancy Group
cC
w
Address City/State O No. of Stories Building Height
O
Zip 905262139 Phone No. V Building Square Footage Stock Plan/Options
-
Front Setback
Rear Setback
0
! •
Z
Z
Right Side Setback Left
Side Setback
• • • •
2
Plat File No. ZBA Case Number
Subdivision/PUD
Zoning District
Filing
(See reverse side for Inspection Description)
F N P
LU
Lot Block Lot Area Parcel No.
G
Name Contractor License No.
OCompany
Address City/State
H
Z
Phone Supervisor Cart. No.
V
Electrical License No.
w
Mechanical
License No.
Roofing
License No.
H
Z
Framing
License No.
V
�Plumbing
License No.
N
T T
Concrete
License No.
INSTALL WATER BOILER
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
Print
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