HomeMy WebLinkAbout2957 Brumbaugh Dr - Permits/Reroof - 07/14/2005Community Planning & Environmental Services
PERMIT
Building & Inspections Division BUILDING P E RM I T
FEES
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 3 5 2 2
$7,554.00
ACCOUNT
FEE
DATE PAID
SITE ADDRESS 7 PERMIT DATE
JOB
PERMITTYPE
�957 BRUMBAUGH DR C l% 14/�'CC5
Building Permit w/o Subs
$68.50
1/14/05
PERMIT LEVEL CATEGORY TYPE
ROOF Roofing - ReRoofin ISSU_FUL Residential
Last Name, First,
CitySales/Use Tax
bn
� � � J 3
)
� � / 14 {� 5
Middle Initial
Construction Type Occupancy Group
NC /CYNTHIAA
.
/
ZZ
Address Wp
County Sales/Use Tax
$30.22
7/14/05
3
City/State No. of Stories Building Height
7 RUMBAUGH DR FORT COLLINS CO 0
O
Zip 80526-6231 223-0281 Phone No. V Building Square Footage Stock Plan/Options
Front Setback Rear Setback
•
Z
Right Side Setback Left Side Setback
•
0
N
Plat File No.
ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
n00
J
wLot
Block Lot Area Parcel No.
0 9728213065
ceCompany
Name Contractor License No.
Address City/State
F—
Z
Phone Supervisor Cert. No.
V
Electrical License No.
OMechanical
License No.
Roofing
License No.
F
ZZ
jjlljjy n�c n rr
Framing
License No.
V
Plumbing
License No.
So
to
Concrete
License No.
TEAR OFF SHAKES AND REROOF WITH 30.75 SQUARES OF CERTANTEED TRI-LAMINATED SHINGLES.
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. Is ermit shall b am e null d void if work authorized by such permit is not
commenced,
suspended, ed or inspected within 180 days fr the ate of su permit or f rF the d of the last inspection.
&7, e -�-/ "0
name of owner/agent Signature Date
Print
TOTAL FEES
$21