HomeMy WebLinkAbout1321 Green St - Permits/Mechanical - 04/03/2006Community Planning & Environmental Services
Building & Inspections Division BUILDING P E RM I T
I PERMIT
P.O. Box 580 281 N. College Ave.
Building Valuation
Fort Collins, CO 80522-0580
City of Fort Collins
$2,630.00
phone (970) 221-6760 Fax (970) 224-6134 B 0 6 0 13 6 1
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS 1321 GREEN ST
PERMIT DATE 04/03/2006
Building Permit w/o Sub
$15.
E 4/3/0
PERMIT
TYPE MECH Mechanical Alteration
PERMIT LEVEL
ISSU_FUL
CATEGORY TYPE Residenti
Last Name First Middle Initial
CAMP$ELL,MATTHEW
Construction Type
Occupancy Group
Addre� 321 GREEN ST
city/state FORT COLLINS, CO
O
No. of Stories
Building Height
O
ZipV
80524 Phone
No. 719 342 5179
Building Square Footage Stock Plan/Options
Front Setback Rear
Setback
Q
O
Z
Z
Right Side Setback Left
Side Setback
• • • •
2
Plat File No.
ZBA Case Number
Zoning District
(See reverse side for Inspection Description)
G i. F N M
gSubdivision/PUD
Filing
J
Lot
Block
Lot Area
Parcel No.
9713408069
OCompany
Name Contractor
License No.
Address City/State
H
ZO
Phone
Supervisor Cert. No.
V
Electrical
License No.
p[
O
Mechanical
HEAT EXCHANGE
License No.
H 1416
Roofing
License No.
F-
OFraming
License No.
V
Plumbing
License No.
V)
Concrete
License No.
INSTALL A/C, HOMEOWNER PULLED PERMIT TO DO ELECTRICAL- B0601381,
HOMEOWNER AFFIDAVIT ON
FILE.
8
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 FEESt5.t3 —