HomeMy WebLinkAbout1318 Coulter St - Permits - 01/06/1992DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769
BUILDING PERMIT
JOB SITE ADDRESS
F Permit Type Work Type
riATER
aProposed se Use ne
RESIDENTIAL
Subdivision ❑ PUD ❑ Filing
Q Subdivision/PUD
0
w
Lot Block Parcel No.
Last First I M.I.
Address
City
O
State
Zip
Phone No.
Company Name
Contractor License No.
OPLUMBING
& HEATING
_
Address
Cityp
Ste
n An
ET
Z
O
Zip
Phone
Sales Tax No.
U
Construction ype
Occupancy Group
Fire Sprinkler
Building Square Footage
No. of Stories
Bldg. Height
Occupant Load
Occupancy Separation
Area Separation
3
No. of Dwelling Units
No. of Bedrooms
No. of Bathrooms
Fireplace/Stoves
Basement
O
Z
O
Text:
GAS WATER HEATER INSTALLATION
t,
N
ZBA Case No. BBA Case No.
Permit No. Permit Date
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 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
information. This permit shall become null and void if the work authorized by
such permit is not commenced, suspended, abandoned, or not inspected within
180 days from the date of such permit.
,Signature Date
ORIGINAL - FILE, BLUE - OFFICE. CANARY - SALESTAX. PINK - APPLICANT. TAG - FIELD CARD
Building Valuation
Type
Fire Containment
Stock Plan Options
SITE SETBACKS
REAR
LEFT RIGHT
FRONT
Area
File No.
St. Parking
CALL 221-6769
TO SCHEDULE INSPECTIONS
(See reverse side for
Inspection Description)
FNP
Electrical
Mechanical
Plumbing