HomeMy WebLinkAbout1621 Mathews St - Permits/Water Heater - 06/16/2009F6rt of
Site Address 1621 MATHEWS ST
Job Valuation $1,500 00 Category Residential
Owner NOVACK ROBERT E
PO BOX 776
WELLINGTON CO 80549
Zoning Front setback Rear setback
Zoning district LMN Plat File #
Legal Subdivision/PUD
Code Res sq ft Com sq ft
# of stories Occ Group
Stock plan #
Contractor LIVERMORE PLUMBING
1425 MT MORIAH RD -
LIVERMORE CO 80536
Subcontractor(s),
Plumbing RMORE PLUMBING r
111
Neighborhood & Building Services
281 N College Ave Fort Collins CO 8o522 o58o
Phone g7o-221-676o Fax 970 224 6134
BUILDING PERMIT # B0903353
Issued Full 06/1612009
Permit Type Residential Plumbing
Phone 481 7483
Right setback Left setback
ZBA Case # Minor Amend #
Filing # Lot # Block #
_ Ind sq ft Basement sq ft
_ Const Type
Stock plan options
— License # MP-659 Supervisor cart #
— Phone 970 567 1867
-I
Phone — License Number
9705671867 MP{59
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L lJ J
Work Description SEPARATE 2 HOT WATER HEATERS 8 RUN SEPARATE LINES
SCHEDULE INSPECTIONS ' By Phone 221-6769 """ By Web http //aaweb fcgov com/CltizenAccess"
Ins ections RP GL FNP UGP FNM FNE
TOTAL FEES PAID AS OF 06/16/09 S53 50 Pavment method Check 2439
Foe Demll Displayed on Neat Pago
As a condition for the Issuance of a pernd I hereby declam that I am the owneror owner's agent authonmd to perform the proposed workon the property desvhbed herein
I agree to oompiy wM all the requirements contained Herein and City ordinances and State lawsassociated vft such work I understard that suds permit may be
revoked in the evert that issuance was brssed m vioorraC irdmrodtm Thin permit shall bemre null and void if the work authorized by such permit is not commenced
suspended ebantlmed or not Inspected within 180 days from the date of such permit
Signature Print Name o �mt CA Date
Form Ravleod Oct 2008
CI*" O� Ne�ghborhood& Ruild�ng Seru�ces
�0�� �o����� 28�N Co(legeAue FortColl�ns C08o522 0580
Phonc 970 22t 676o Fax 97� =23-6�34
/ �� BUILDING PERMIT# 60903353
Issued Full 06/1612009
Pertmt Type Resident�al Plumbing
Site Address 1621 MATHEWS ST
Job Valuation 1 500 00 Category Res�denhal
Transaetlons
��QQ Check Number Date Pa�d Amount Paid Comments
Check CK#2439 O6l16/2009 S53 50 PAID BY JUSTIN FRANZ CK #2439
Rece�pt issued 06/16/2009 Total Paid to Date S53 50
Fee DescrfDtion Account Code Fee Amount Amount Paid Date Paid Amount Due
Building Pertnit Fee Without 1000 422010 $25 00 525 00 O6/16/2009 SO 00
Subs
City Sales/Use Tax 251 122030 $22 50 S22 50 O6I16I2009 SO 00
County Sales/Use Tax 100 217030 $6 00 $6 00 O6/162009 $0 00
TOTAL FEES $53 50 $53 50 SO 00
= r
- - , ; � -
� ' �' � -TOTAL BALANCE DUE AS OF 06/16/Z009 0 00
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Fee Amounts are valid for date ot thia document only Fees subJect to change without notieo
Fortn RwbsA Ocl 2008