HomeMy WebLinkAbout412 10th St - Permits/Mechanical Alteration - 05/14/2004Community Planning & Environmental Services
Ea Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
CityofFort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 412 1 OTH ST
PERMIT TYPE PER
MECH Mechanical Alteration
Last Name, First, Middle Initial
3 w Address
City/State
0 Zip
_ _ __ _I Phone No.
0
Z Right Side Setback Left Side Setback
Z
Plat File No. ZBA Case Number Zoning
Q - Filing
wLot Block Lot Area Parcel
Company Name Contractor Licensee No.
O
H
I Address
City/State
H
Z Phone
License No,
c. 0echanic
Mal
License No.
H
Roofing
License No.
H
0
Framing
License No.
V
co
Plumbing
License No.
N
Concrete
License No.
INSTALL AC
8
w
BUILDING PERMIT
Building Valuation
80402812 ACCOUNT
PERMIT DATE
05 4 2004 Building Persit w/o Subs
EVEL I CATEGORY TYPE
--ruction Type Occupancy Group
Ow No. of Stories
Building Height
V
Building Square Footage I Stock Plan/Options
(See reverse side for Inspection Description)
CL FNM
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.
FEE DATE PAID
$15.0 5/14/04
Print name of owner/agent Signature
Date
TOTAL FEES