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HomeMy WebLinkAbout2228 Country Club Rd - Permits/Electrical - 07/12/2005Community Planning & Environmental Services Building & Inspections Division (MMM P.O. Box 580 281 N. College Ave. Fort Collins, CO 80522-0580 City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 10B SITE ADDRESS ,,,Q MI IAIToV /M 110 13M Last Name, First, Middle Initial W Address City/State 3 Zip 80026 Phone No. Front Setback Rear Setback Z_ Right Side Setback Left Side Setbac Z Plat File No. ZBA Case Number a _W Lot Block O- Company Name QAddress raeancai License No. n Mechanical License No. O Roofing License No. H Z Framing License No. V j Plumbing License No. h Concrete License No. INSTALL ELECTRIC IRRIGATION METER Zoning District Parcel No. she No. BUILDING PERMIT Building Valuation B0503474 I ACCOUNT FEE PERMIT DATE LEVEL Construction Type Occupancy Grc Wp No. of Stories Building Height O V Building Square Footage Stock Plan/Options (See reverse side for Inspection Description) FNE E0 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. Building Permit w/o Subs ai5.01 �N NM/ /�<<ify!� f>l L.�i✓ �� ✓ � �'� " ®S TOTAL Print name of owner/agent Signature Date AL FEES $Z�JI DATE PAID 7/12/05