HomeMy WebLinkAbout800 Butte Pass Dr - Permits/Reroof - 06/28/2005Community Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
CityofFortCollins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 80o BUTTE PASS DR
PERMITTYPE PEF
ROOF Roofing - ReRoofing
Last Name, First, Middle Initial
0:: GUBIN, DAVID S
w59 Address City/State
3 800 BUTTE PASS DR FORT COLLINS, C
0 Zip Phone No.
80526-3560 484-8476
Front Setback Rear Setback
0
Z_ Right Side Setback Left Side Setback
Z
2 Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
J
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Lot Block Lot Area Parcel No.
In8,1)soi
BUILDING PERMIT
Building Valuation
B0503184 ACCOUNT
PERMIT DATE
v/,IO,) Building Permit w/0 Suus
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.EVEL CATEGORY TYPE
ISSU FUL Residential City Safes/Use Tax
Construction Type Occupancy Group
County Saes/Use Tax
Wp No. of Stories Building Height
OBuilding Square Footage Stock Plan/Options
6008
Company Name Contractor License No.
ATLAS "OOFiBO 'a CCIIST CI i 5 4
Address City/State TT
525 S. TAFI BILL IU F0"T GOLLDiS C0 80521
Phone Supervisor Cert. No.
970 484 7777
W
Mechanical
License No.
O
Roofing
License No.
Framing
License No.
O
V
m
Plumbing
License No.
V)
to
Concrete
License No.
W
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(See reverse side for Inspection Description)
t IV,t:
TEAR OFF AND REROOF USING 16 2/3 SQUARES - TAXES ON MATERIAL COST $590.00
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.
FEE MATE PAID
$28.00 6/28/05
$17.1 6/28/05
$4.12 6/28/05
Print name of owner/agent
Signature
Date
TOTAL FEES 1'' $50.�