HomeMy WebLinkAbout2801 Dixon Creek Ln - Permits/Water Heater - 01/22/2004Community Planning & Environmental Services
Building & Inspections Division
i 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 2801 DIXON CREEK LN
PERMIT TYPE PEF
WTRHTR Water Heater
Last Name, First, Middle Initial
a
LU
Z Address City/State
Z
32801 DIXON CREEK LN FORT COLLINS,c
O Zip Phone No.
80526 225-6441
Front Setback Rear Setback
0
Z_ Right Side Setback Left Side Setback
Z
Plat File No. ZBA Case Number Zoning District
Q
w [Lot
J
aAddress
H
O Phone
V
Electrical
Mechanical
� nl
Roofing
H
Z Framing
O
V
m Plumbing
V)
N
Block Lot Area n Parcel No.
v
Contractor License No.
City/State
Supervisor Cert. No.
License No.
License No.
T n U nC
License No.
License No.
License No.
License No.
INSTALL WATER HEATER
BUILDING PERMIT
Building Valuation
B0400330 ACCOUNT
PERMIT DATE
12 22JG4 Bui1dirig Perm 'It w/o SubsLEVEL I CATEGORY TYPE
Construction Type Occupancy Grc
Wp No. of Stories Building Height
O
V
Building Square Footage Stock Plan/Options
(See reverse side for Inspection Description)
F11P
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.
FEE DATE PAID
,v 15 u I (LLJ U4
Print name of owner/agent
Signature
Date
TOTAL FEES