HomeMy WebLinkAbout1638 Ukiah Ln - Permits/Air Conditioner - 06/28/2005Community Planning &Environmental Services BUILDING PERMITPERMIT FEES
Building & Inspections Division
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 5 0 313 6 $7,558.00
ACCOUNT FEE DATEPAID
PERMIT DATE
JOB SITE ADDRESS 1638 UKIAH LN o ,/�'�,/ c;U5 Building Permit w/o Subs $15,0 6/28/e5
PERMIT TYPE PERMIT LEVEL CATEGORY TYPE
MECH Mechanical Alteration iSSU_FUL Residential
Last Name, First, Middle Initial
HANSEN, LAVERNE/MARLYS
Z Address City/State
3 1638 UKIAH LN I FORT COLL'NS. CO
Zip Phone No.
80525 229-0902
Front Setback Rear Setback
0
Z_ Right Side Setback Left Side Setback
Z
0 Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
J
Q
wLot Block Lot Area 4 Parcel No.
972416600/
Qd Comoanv Name I Contractor License No.
Address
Phone
License No.
W
Mechanical
License No.
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H 13f�
RED LitiE i;EAiY
V t
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Roofing
License No.
H
Z
Framing
License No.
O
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Plumbing
License No.
V)
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Concrete
License No.
INSTALL AIR CONDITIONER WITH AIR HANDLER
8
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LU
p No. of Stories Building Height
OI Building Square Footage I Stock Plan/Options
(See reverse side for Inspection Description)
tu'L 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.
Print name of owner/agent
Signature
Date
)TAL FEES $15.0