HomeMy WebLinkAbout4270 Southshore Ct - Permits/Reroof - 07/18/2006Community Planning & Environmental Services
drBuilding & Inspections Division BUILDING PERMIT
PERMIT
FEES
I 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 B 0 6 0 31 53
SITE ADDRESS PERMIT DATE
ACCOUNT
FEE
DATE :PAID
JOB
S CT 07/ `, / `
Building Permit w/o Sub
$4 d .
iO 7 / 18 / 0
PERMIT
TYPE
PERMIT LEVEL
CATEGORY TYPE
City
�y Sales/Use Tax
$60.
0 7/18/0
Last Name, First, Middle Initial
Construction Type
Occupancy Group
W
Address City/State
County Sales/Use Tax
$16.
0 7/18/0
O No. of Stories
Building Height
'
I
ZipECT
FORT COI
Phone No.
V
Building Square Footage Stock Plan/Options
Front Setback
Rear Setback
_Z
Z
Right Side Setback Left
Side Setback
• • • •
Plat File No. ZBA Case Number
Subdivision/PUD
Zoning District
Filing
(See reverse side for Inspection Description)
�Q0
J
wLot
Block Lot Area Parcel No.
Name Contractor License No.
OCompany
rj
n n 'NG
Addres
City/State
O
�
,41i AVE
FORT COLLiNs, Go
5
Phone Supervisor Cert. No.
V
n n1388
Electrical License No.
W
Mechanical
License No.
C
Roofing
License No.
Framin M ROOFING
License No. 400
Z
V
SO
Plumbing
License No.
rn
Concrete
License No.
TEAR OFF TO DECKING AND REROOF WITH AO SQUARES
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.
�:mj-�LA#a- too °
Print
name of owner/agent Signature Date?
TOTAL FEES
120.