HomeMy WebLinkAbout613 Mansfield Dr - Permits/Furnace - 01/07/2004Community Planning &Environmental Services
Building & Inspections Division BUILDING PERMITPERMIT
FEES
P.O. Box 580 281 N. College Ave.
Building valuation
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B N 0 0 0 5
ACCOUNT
FEE
DATE PAID
JOB
PERMIT DATE
SITE ADDRESS
PERMITTYPE
613 MANSFIELD DR r i
Q 1 v i7 / 21OG4
i
Bultuing Permit N/o Subs
PERMIT LEVEL
MECH Mechanical Alteration ISSU_FUL CATEGORY TYPE Residential
Last Name, First, Middle Initial Construction Type Occupancy Group
DANIEL, DON J/BARBARA J
Z
3
Address City/State p No. of Stories Building Height
613 MANSFIELD DR FORT COLLINS, CO 0
Phone No. - Building Square Footage Stock Plan/Options
Zip 970-226-4504
80525-2708
Front Setback
Rear Setback
Z_
Z
Right Side Setback Left Side Setback
• •
Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
ofUL FNM
J
Block Lot Area Parcel No.
wLot
�t 7
0 9725412161
Company Name Contractor License No.
U
Address City/State
F
Z
Phone Supervisor Cert. No.
V
Electrical License No.
ce
Mechanical
'(
License No.
O
AIRCOMFOpl, T
94
d
Roofing
License No.
Z
0
Framing
License No.
Plumbing
License No.
SO
Concrete
License No.
FURNACE REPLACEMENT
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 180 days from the date of such permit or from the date of the last inspection.
f�nn& gM,1n&jtWrje� , -� . D y
name of owner/agent Signature Date
Print
TOTAL FEES
$15 0