HomeMy WebLinkAbout805 Birky Pl - Permits/Water Heater - 12/16/2003Community Planning &Environmental Services BUILDING P E RM I T
PERMIT FEES
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Building Valuation
�i Fort Collins, CO 80522-0580
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City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 3 0 7 9 3
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
"2 1` 20031
Building Permit w10 Subs
$15.0
12/16/0',
805 BIRKYPL
1 !_ Li L V J
PERMIT
TYPE
PERMIT LEVEL
CATEGORY TYPE
WTRHTR Water Heater
iSSU FUL
Residential
Last Name, First, Middle Initial
Construction Type
Occupancy Group
w
Address
City/State
WQ No. of Stories
Building Height
Z
3
U
Zip
Phone No.
Building Square Footage Stock Plan/Options
O
80526-1909
493-9283
ri
Front Setback
Rear Setback
Right Side Setback
Left Side Setback
Z_
(See reverse side for Inspection Description)
G 14 P
Plat File No. ZBA Case Number
Subdivision/PLID
Zoning District
Filing
_
Q
wLot
Block Lot Area Parcel No.
J
O 9722207014
Name Contractor License No.
OCompany
u
Q
Address City/State
dH
Z
O
Phone Supervisor Cert. No.
U
Electrical License No.
Mechanical
License No.
U
Roofing
License No.
H
License No.
OFraming
U
m
Plumbing
License No.
N
I VAj4AQ Mo tinMR
247
Concrete
License No.
REPLACE WATER HEATER
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 vyid if the work authorized by such permit is not
comme
a date of the last inspection.
ed, suspended, abandoned or inspected within 180 days from the qpke of such permit ortK
LG'
TOTAL FEES
$1 D
name of oer/ag ignature Date
wn
rint