HomeMy WebLinkAbout631 Lupine Dr - Permits/Addition or Alteration - 03/30/2004Community Planning & Environmental Services
Building & Inspections Division
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
Last
BUILDING PERMIT
Building Valuation
B0401189 $2,000.00
ACCOUNT FEE DATE PAID
PERMIT DATE
03/30/2004 Buildlrg Permit w/ Subs $43.8 3/30/04
PERMIT LEVEL CATEGORY TYPE
ISSU_FUL Residential Remodel City Sales/Use Tax $30.0 3/30/04
Construction Type Occupancy Group
WAUNEH, ANTHONY 5N R_3 County Sales/Use Tax $8.0 3/30/04
Z Address Gity/State p No. of Stories Building Height
Z 631 LUPINE DR FORT COLLINS, CO O
O Zip Phone No. V Building Square Footage I Stock Plan/Options
80524-2351 224-4502 n
SITE ADDRESS 631 LUPINE DR
E
MIN-ALT Minor Residential Alteration
Z_ Right Side Setback Left Side Setback
Z
2 Plat File No. ZBA Case Number Zoning District
WLot Block Lot Area Parcel No.
9701417001
a Company Name I Contractor License No.
Address
Phone
(See reverse side for Inspection Description)
RP RM GL
IN FMB FNE
FNP FNM Spi
UCP FR FP
RE
Electrical License No.
p- Mechanical License No.
Roofing License No.
Framing License No.
mPlumbing License No.
V)
Concrete License No.
REMODEL EXISTING WALK-IN CLOSET AREA OF MASTER BEDROOM INTO 3/4 BATH
HOMEOWNER AFFIDAVIT ON FILE - HOMEOWNER TEST ON FILE
t-
As a condition for the issuance of a permit, I hereby declare that 1 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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Print name of caner/agent Sig ure Dates TOTAL FEES $$ },