HomeMy WebLinkAbout6214 Tilden St - Permits/Air Conditioner - 08/07/2006Community Planning & Environmental Services BUILDING P E RM I T
_. Building & Inspections Division
= P.O. Box 580 281 N. College Ave.
Building valuation
Fort Collins, CO 80522-0580
Cityof Fort Conins phone (970) 221-6760 Fax (970) 224-6134 B060378
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
o - „
Building Permit w/o Sob
$15.
a 8/1/0
PERMITTVPE
PERMIT LEVEL
CATEOORV TYPE
City Sales/Use Tax
$45.
0 8/710
Last Name, First, Middle Initial
Construction Type
Occupancy Group
Csuoty Sales/Use Tax
$12.
U 8/7/C
Address
GAy/State
p No. of Stories
Building Height
Z
O
Zip Phone
No.
Building Square Footage Stock Plan/Options
Front Setback Rear
Setback
a
Z_
Right Side Setback Leff
Side Setback
Z
• •
2
(See reverse side for Inspection Description)
O L r N M
Plat Pile No. zBA Case Number
Subdivision/PUD
zoning District
Filing
Q
wLot
Block Lot Area Parcel No.
Name Contractor License No.
OCompany
G
n e
Addres City/State
Phone Supervisor Cert. No.
V
g
Electrical License No.
y
ME 84
MechaRUPTHWES4 UNITE.9License
Na
Reofin PROBUOTS
License No.
ZFraming
0
License No.
m
N
Plumbing
License No.
Concrete
License No.
ADD ON AIR CONDITION
/ 1
V
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 18 days from the date of such permit or from the date of the last inspection.
IBIS
name of owner/agent Signature Date
TOTAL FEES
72.
0
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