HomeMy WebLinkAbout2619 Belgian Ct - Permits/Water Heater - 11/03/2009Fort Collins
Site Address 2619 BELGIAN CT
Job Valuation $1,609 00 Category Residential
Owner STOLARCZYK CHESTER W
2619 BELGIAN CT
FORT COLLINS CO 80526 1156
Zoning Front setback Rear setback
Zoning district RL Plat File #
Legal Subdivision/PUD
Code Res sq ft Com sq ft
# of stories Occ Group
Stock plan #
Contractor BEN FRANKLIN PLBG/NO COLO
1833 E HARMONY RD STE 2
FORT COLLINS CO 80528\�
Neighborhood & Building Services
281 N College Ave Fort Collins CO 80522 o58o
Phone 970 221 676o Fax 970 224 6134
BUILDING PERMIT # B0906468
Issued Full 11/03/2009
Permit Type Residential Water Heater
Phone
_ Right setback Left setback
ZBA Case # Minor Amend #
Filing # Lot # Block #
Ind sq ft Basement sq ft
Const Type
Stock plan options
r, License # MP 598 Supervisor cart #
Phone 970 488 2419
Subcontractor(s1—� 7 I I/ Phone License Number
Plumbing BEN FRANKLIN PLBG/NO COLO C7o
2419 ❑ MP 598
O
Work Description INSTALLED WATER HEATER
II " SCHEDULE INSPECTIONS " By Phone 221-6769 " By Web http //aaweb fcgov com/CitizenAccess �I
Ins ections FNP FNE FNM
TOTAL FEES PAID AS OF 11/03/09 5 59 Payment method Trust Account
Fee Derail Displayed on Next Page
As a condition for the issuance of a permit I hereby declare that I am the owneror owners agent authorized to perform the proposed work on the property described herein
I agree to comply with all the requirements contained herein and 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 irdonnabon This permit shall beam a null and void if the work authorized by such permit is not commenced
suspended abandoned or riot inspected whin 180 days from the date of such permit.
Signature Print Name Date
Form Revised Oct 2008
Fort Collins
Site Address 2619 BELGIAN CT
Job Valuation $1,609 00 Category Residential
Transactions
Method Check Number Date Paid
Trust Account 11/03/2009
Receipt issued 11/03/2009 Total Paid to Date
Fee Description Account Code
City Sales/Use Tax 251 122030
County Sales/Use Tax 100 217030
Permit Flat Fee w/o Subs $15 1000 422010
Amount Paid
$45 59
$45 59
Neighborhood & Building Services
281N College Ave Fort Colhns CO80522 o58o
Phone 970 221 676o Fax 970 224 6134
BUILDING PERMIT # B0906468
Issued Full 11/03/2009
Permit Type Residential Water Heater
Comments
BEN FRANKLIN PLBG/NO COLO
Fee Amount
Amount Paid
$24 15
$24 15
$6 44
$6 44
$1500
$1500
Date Paid
Amount Due
11/03/2009
$0 00
11103/2009
$0 00
11/03/2009
$000
TOTAL FEES $45 59 $45 59 $0 00
J �
TOTAL BALANCE DUE AS OF 11/03/2009 0 00
>J ❑
O O
Fee Amounts are valid for date of this document only Fees subject to change without notice