HomeMy WebLinkAbout1104 Newsom St - Permits/Plumbing - 06/06/2003Community Planning &Environmental Services BUILDING PERMITPERMIT
Building & Inspections Division
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 3 Q 3 3 4
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS1104 NEWSOM ST
PERMIT DATE 06/06/2003
I
luilding Permit w/o Subs
$44.50
6/6/03
PERMIT
TYPE
PLUM Plumbing Alteration
PERMIT LEVEL
ISSU_FUL
CATEGORY TYPE
I Residential
Last Name, First, Middle Initial
Construction Type
Occupancy Group
oe
FLANAGAN, JOHN A
Z
-
Address
City/State
p No. of Stories
Building Height
1104 NEWSOM ST
I FORT COLLINS, CO
U
0
Zip
Phone No.
Building Square Footage Stock Plan/Options
80524-3861
484-2702
Front Setback
Rear Setback
414
Z_
Right Side Setback Left Side Setback
• •
Z
'
2
Plat File No. ZBA Case Number Zoning District
Subdivision/PLID Filing
(See reverse side for Inspection Description)
RP G i F N P
J
Q
wLot
Block Lot Area Parcel No.
J
0 9713408203
Name Contractor License No.
OCompany
Address City/State
Z
Q
Phone Supervisor Cert. No.
V
Electrical License No.
Q�
Mechanical
License No.
'..
Roofing
License No.
H
Z
Framing
License No.
m�
Plumbing
License No.
rn
-
Concrete
License No.
INSTALL REPLACEMENT BOILER
.V
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 sucFrp mit or from the date of the last inspection.
tzr t
name of owner/agent Signature Date$44.50
�TOTAL fEESPrint