HomeMy WebLinkAbout4920 Mcmurry Ave - Permits/Reroof - 08/09/2004 (3)Community Planning & Environmental Services
BUILDING P E RM I T
PERMIT FEES
Building & Inspections Division
m� 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 5 1 1 2
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
4920 MCMURRYAVEL
08 O92004
Building Permit w/o Subs
$38.50
8/9/04
PERMIT
TYPE
PERMIT LEVEL
CATEGORY TYPE
ROOF Roofing - ReRoofin
ISSU FUL
Residential
City Sales/Use Tax
$36.00
8/9/04
Last Name, First, Middle Initial
Construction Type
Occupancy Group
Ine
Address City/State
County Sales/Use Tax
$9.60
8/9/04
w
Z
wQ No. of Stories
Building Height
PO BOX 271155 1 FORT COLLINS- CO
0
Zip
Phone No.
U Building Square Footage Stock Plan/Options
223-7070
Front Setback
Rear Setback
, •
0
Right Side Setback
Left Side Setback
• • • •
Z
Plat File No. ZBA Case Number
Subdivision/PUD
Zoning District
Filing
(See reverse side for Inspection Description)
R00
N
J
wLot
J
Block Lot Area Parcel No.
Name Contractor License No.
OCompany
V
Address City/State
ZZ
Phone Supervisor Cert. No.
U
Electrical License No.
W
R
Mechanical
License No.
Roofing
License No.
f
Fra i
License No.
Z
U
Plumbing
License No.
N
Concrete
License No.
TEAR OFF AND REROOF WITH 24 SQUARES
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 inspected within 180 days from the date of ch ermit rom the date of the last inspection.
name of owner/agent Signature Date Z.
Print
TOTAL FEES
$941