HomeMy WebLinkAbout4267 Kingsbury Dr - Permits/Water Heater - 06/02/2006Community Planning & Environmental Services
Building & Inspections Division
i P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
CityofFort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 4267 KINGSBURY DR
PERMITTYPE WTRHTR Water Heater PER
Last Name, First, Middle Initial
ce SZAMEL. GRZEGORZ
Address City/State
4267 KINGSBURY DR FORT
Q Zip Phone No.
80525-3313 225-2680
Front Setback Rear Setback
Q
Z_ Right Side Setback Left Side Setback
Z
2 Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
J
wLot Block Lot Area Parcel No.
J A731.
COLLINS,
CompaAA Name
R I C A N SERVICES, 'INC Contractor License No. M P 315
Address iiii City/State
513 A N. LINK LN FORT COLLINS, CO
Phone970482 8141 Supervisor Cert. No.
Electrical
License No.
Mechanical
License No.
O
153
Roofing
License No.
Framing
License No.
Q
m
Plumbing
License No.
N
AMERICAN SERVICES, INC
MP 315
Concrete
License No.
INSTALLATION OF 50 GALLON WATER
HEATER
18
BUILDING PERMIT
Building Valuation
B0902902 ACCOUNT
PERMIT DATE , 2 y .f
Cfr3/G�, L.008 Building Permit w/o
RMIT LEVEL CATEGORY TYPE ISSU_FUL Residenti
Construction Type Occupancy Group
Wp No. of Stories Building Height
CO O Building Square Footage Stock Plan/Options
INSPECTIONSREOUIRED
CALL •
31S119
805
(See reverse side for Inspection Description)
FNP
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.
`999.00
FEE DATE PAID
Sub i $15. 0 6/2/0
Print name of owner/agent
Signature
Date
TOTAL FEES
$1