HomeMy WebLinkAbout1052 Briarwood Rd - Permits/Water Heater - 01/23/2004I
Community Planning &Environmental Services BUILDING PERMIT
PERMIT FEES
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Building valuation
i Fort Collins, CO 80522-0580
Citv of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 4 0 0 3 6
ACCOUNT
FEE
DATE PAID
JOB SITE ADDRESS 1052 BRIARWOOD RD
PERMIT DATE
11) 1 '2304
Building Permit w/o Subs
City Sales/Use Tax
im
County Sales/Use Tax
$15.0
$4.5
$1.2
l W) 04
1/23/04
1/23/04
PERMIT TYPE
WTRHTR Water Heater
PERMIT LEVEL
ISSU FUL
CATEGORY TYPE
Residential
Last Name, First, Middle Initial
Construction Type
Occupancy Group
LU
Address
City/State
Wp No. of Stories
Building Height
Z
O
Zip
Phone No.
Building Square Footage I Stock Plan/Options
Front Setback
0
Z_ Right Side Setback
Z
N Plat File No.
Subdivision/PU D
J
Q
w Lot
J
OCompany Name
H
QAddress
r-
Z Phone
ag: Mechanical
0
H
Roofing
H
Z Framing
0
V
m Plumbing
V)
484-8984
Rear Setback
Left Side Setback
ZBA Case Number Zoning District
Filing
Block Lot Area Parcel No.
O
Contractor License No.
City/State
Supervisor Cert. No.
License No.
License No.
License No.
License No.
License No.
License No.
INSTALL 40 GALLON GAS WATER HEATER
(See reverse side for Inspection Description)
HNP
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, suspe fed bandoned or inspected within 180 days from the date of such permit or from the date of the last inspection.
Print name of owner/agent
Signature
Date
TOTAL FEES