HomeMy WebLinkAbout200 W Foothills Pkwy - Permits/Demolition - 03/15/2004Community Planning &Environmental Services PERMIT
Building & Inspections Division BUILDING PERMIT
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 0 4 0 1 3 3 4
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FEE
DATE PAID
ACCOUNT
SITE ADDRESS 200 W FOOTHILLS PK` PERMIT DATE ^
JOB
PERMIT
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PERMIT LEVEL CATEGORY TYPE
DEMO Demolition ISSU_FUL Non Res Bldg Const
Last Name, First, Middle Initial Construction Type Occupancy Group
ONE COMPONENT PARK
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Address City/State LU
a No. of Stories Building Height
P.O. BOX 478 WEST BRIDGEWATER, O
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Zip Phone No. U Building Square Footage Stock Plan/Options
02379 508-583-9055
Front Setback Rear Setback
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Right Side Setback Left Side Setback • •
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Plat File No. ZBA Case Number Zoning District (See reverse side for Inspection Description)
Subdivision/PUD Filing S o u i ti u
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Block Lot Area Parcel No.
Q 972643300I
Company Name Contractor License No.
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Address City/State
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Phone Supervisor Cert. No.
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Electrical License No.
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Mechanical License No.
Roofing License No.
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OFraming
License No.
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Plumbing License No.
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Concrete License No.
INTERIOR NON-STRUCTURAL DEMOLITION (WILD OATS) REMOVING INTERIOR WALLS, GRINDING
EXSITING FLOORING. TRENCHING FOR UNDERGROUND PLUMBING TO BE INSTALLED ON TENANT FINISH
PERMIT
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OWNER AUTH. FORM ON FILE
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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.
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name of owner/agent��� SIgIT'�ture ,_� � � ��� Date S G
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TOTAL FEES
$15 0