HomeMy WebLinkAbout416 N Meldrum St - Permits/Water Heater - 01/12/2004Community Planning &Environmental Services BUILDING
� I �D I I� G PERMIT
Building & Inspections Division
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 0 4 0 0 1 8
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS 416 N MELDRUM ST
PERMIT DATE
0 I ' 1 2'L0)C4
BuHld'lay Flernit w;o Subs
$15.0
'/':2/04
PERMIT
TYPE
PERMIT LEVEL
CATEGORY TYPE
WTRHTR Water Heater
ISSU FUL
Residential
Last Name, First, Middle Initial
Construction Type
Occupancy Group
ARLE E. S AWN
ZLU
Address
City/State
in No. of Stories
Building Height
3416
N MELDRUM ST #A
FORT COLLINS, CO
0
V
Zip
Phone No.
Building Square Footage Stock Plan/Options
O
80521
412-5255
Front Setback
Rear Setback
:)
Z_
Right Side Setback Left Side Setback
• • • •
Z
0
Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
FNP
_
Q
wLot
Block Lot Area Parcel No.
J
0 own
Name Contractor License No.
OCompany
V
a
Address City/State
Z
O
Phone Supervisor Cert. No.
V
Electrical License No.
j3�:
Mechanical
License No.
Roofing
License No.
H
Z
Framing
License No.
V
Plumbing
License No.
m
A P ^T '�
n 4 1
Concrete
License No.
WATER HEATER REPLACEMENT
V
As
a condition for the issuance of a permit, I hereby declare that I am an owner o 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 ass late with such wor . nderstand that such permit may be revoked in the
event
that issuance was based on incorrect or incomplete information. This pe t sh II become null nd oid if the work authorized by such permit is not
commenced,
suspended, andoned or inspected within 180 days from the of s ch permit orto a date of the last inspection.
name om wner gent Signature Dates—�
TOTAL FEES
$15.
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