HomeMy WebLinkAbout3001 Meadowlark Ave - Permits/Air Conditioner - 06/17/2005Community Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
(am% =%Mml: Fort Collins, CO 80522-0580
City of FortCollins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS �,, ,.. ,�.......... �....._
Last Name, First, Middle Initial —"
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Address
City/State
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Zip
Phone No.
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Front Setback
Rear Setback
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Right Side Setback
Left Side Setbacl
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Plat File No. ZBA Case Number
Zoning District
BUILDING PERMIT PERMIT FEES
Building Valuation
B050290 ACCOUNT FE' f AID
PERMIT LEVEL
wLot Block Lot Area Parcel No.
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9E I Company Name I Contractor License No.
City/State
Phone
Electrical
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License No.
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License No.
License No.
OFraming
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Plumbing
License No.
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Concrete ILicense No
INSTALL NEW AIR CONDITIONER
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PERMIT DATE CATEGORYTYP1. 6 1..1/ 2/' ), - Bui1diflg:,Permtt who Subs ... :...�I3.Q. u�Ii%UJ
Oristruc ion Type Occupancy Group
ONo. of Stories Building Height
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Building Square Footage I Stock Plan/Options
(See reverse side for Inspection Description)
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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.
Print name of owner/agent
Signature
Date
TOTAL FEES I� c