HomeMy WebLinkAbout5025 Bluestem Ct - Permits/Water Heater - 12/23/2003Community Planning & Environmental Services
Building & Inspections Division
- P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 5025 BLUESTEM CT
PERMIT TYPE pE
1NTRHTR Water Heater
Last Name, First, Middle Initial
PER
�
MAIM I MAN JAY
Z
Address
City/State
3
5025 BLUESTEM CT
FORT COLLI
O
Zip
Phone No.
80525
412-6978
Front Setback
Rear Setback
0
Z_
Right Side Setback Left Side Setback
Z
Plat File No. ZBA Case Number Zoning District
Q
wLot Block Lot Area Parcel No.
J ^
Address City/State
Phone Supervisor Cert. No.
Electrical License
a
O
iwecnanicai
License No.
N
N
Roofing
License No.
Z
Framing
License No.
0
V
SO
Plumbing
License No.
N
nCcin rnccu nI IIYOT►Ir+
Concrete I License No
INSTALL 50 GALLON GAS WATER HEATER
BUILDING PERMIT
Building Valuation
�Q��� ACCOUNT
PERMIT DATE
i � v Builuing ieimI V/0 SUbs
LEVEL CATEGORY TYPE
ISSU FUL Residential City Sales/Use Tax
Construction Type Occupancy Group
County Sales/Use Tax
in No. of Stories Building Height
10 O
Building Square Footage I Stock Plan/Options
(See reverse side for Inspection Description)
FNP
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, suspen , abandoned or inspected within 180 days from the date of such permit or from the date of the last inspection.
FEE DATE PAID
$15.0 12/23/03
$4.5 12/23/03
$1.2 12/23/03
Print name of owner/agent
Signature
Date
TOTAL FEES
$20.