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HomeMy WebLinkAbout1841 Busch Ct - Permits/Reroof - 02/20/2004Community Planning &Environmental Services BUILDING P E RM I TPERMIT FEES 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 ������ �` nn ACCOUNT FEE DATE PAID JOB SITE ADDRESS PERMIT DATE 1 U S (' %� i ') !) i �) !� (`, .^. i.rm;t p � l C„U p J i if rig 2� 111 ! W/ J U V S L fi1j $ ,) . 5 � l�C jitA L r inn it 4 PERMIT TYPE PERMIT LEVEL CATEGORY TYPE ROOF Roofing - ReRoofin c t t I.,SJ FUG I Residential r;t I City Sales/Use Tax $35.4 n nA 2/2„/v4 Last Name, First, Middle Initial Construction Type Occupancy Group EUGENE H I r t o tU Ta. v01fi y udicS/uS"c InA $ A y�.y o In In A e/c /u� w Z Address City/State w No. of Stories Building Height 3 1841 SURCHIZI in O Zip Phone No. U Building Square Footage Stock Plan/Options 5 5-15 484-6168 Front Setback Rear Setback ' Z Right Side Setback Left Side Setback • • • Z � • Plat File No. ZBA Case Number Zoning District (See reverse side for Inspection Description) ^ )n Ix J Subdivision/PUD Filing Q wLot Block Lot Area Parcel No. J 072/090019 Ce Company Name Contractor License No. c nnrrrA,n rnucT cR City/State ZAddress rl75 C TACT 1 (ln CnnT P,11 T It I`0 .5 nG 2f Phone I Suoervisor Cert. No. Electrical I License No. ce Mechanical License No. 0 Roofing License No. H Z Framing License No. U m U) Plumbing License No. N Concrete License No. REMOVE AND REPLACE 28 1/3 SQUARES OF WOOD SHAKES WITH ASPHALT SHINGLES - TAX BASED ON w1180 MATERIALS. 8 w 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 fro the d to of such permit or from the date of the last inspection. Print name of owner/agent Sign tur Date TOTAL FEES