HomeMy WebLinkAbout1107 Doral Pl - Permits/Gas - Log, Line, Pipe - 08/14/2003�� Community Planning & Environmental Services
6 Building & Inspections Division BUILDIF
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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 Q 3 0 5 3 ?
:]ACCOUNT
0
FEE
DATE PAID
DATE
JOB SITE ADDRES51107
DORALPL EPERMIT
/
PERMITTYPE �u/t I4/ 20031
u11di � Dermit w/D Subs
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�u/i4f/u�SLOG
Gas L Gas LI hter PERMIT LEVEL tCATEGOPE
g lSSJ_FUL Residential
Last Name, First,
f
i ty Sales/{,se Tax
n n
y 1 c vo
S / 1 4 / u,)
Middle Initial
Construction Type Occupancy Group
SANFORD JIM
.
ui
Z Address City/State p No. of Stories Building Height
3 1107 DORAL PL
ounty SaleS/Use Tax
$?.20
8/14/03
FORT COLLINS, CO O
Zip V
Phone No. Building Square Footage Stock Plan/Options
80525 223-7102
Front Setback Rear Setback
Z_
Z
Right Side Setback Left Side Setback
• •
Plat File No.
• • •
• JIM
ZBA Case Number Zoning District
(See reverse side for Inspection Description)
u i i. S
Subdivision/PLID
Filing
Lot Block Lot Area Parcel No.
wQ
g 8607219008
O
Company Name Contractor License No.
V
Address City/State
F
ZZ
Phone Supervisor Cert. No.
V
Electrical
License No.
OMechanical
License No.
Roofing
License No.
H
Z
Framing
License No.
V
Plumbing
License No.
h
Concrete
License No.
INSTALL GAS LINE AND GAS DIRECT VENT FIREPLACE
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, abann^doned or inspected within 180 days from the date of such
the date of the last inspection.
L_eafrom
Print name of owner/agent signature Date
TOTAL FEES
530 20