HomeMy WebLinkAbout2933 Bassick St - Permits/Reroof - 08/15/2005Community Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
c;tvofFo>�co><lins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 2933 BASSICK ST
PERMIT TYPE PER
ROOF Roofing - ReRoofing
Last Name, First, Middle Initial
LANE, GALL CIFREDRICK W
Z Address City/State
3 2933 BASSICK ST I FORT COLLINS,
O Zip Phone No.
80526 225-9933
BUILDING PERMIT
Building Valuation
B0504517
ACCOUNT
PERMIT DATE
Z. i Building Permit w/c Subs
MIT LEVEL CATEGORY TYPE
ISSU_FUL Residential
Construction Type Occupancy Group
ONo. of Stories Building Height
V
Building Square Footage I Stock Plan/Options
FEE DATE PAID
$Ja.S B(I�/VJ
Front Setback Rear
Setback
Z_
Right Side Setback Left Side Setback
' • • •
Z
N
Plat File No.
ZBA Case Number Zoning District
(See reverse side for Inspection Description)
_
Subdivision/PUD
Filing
Q
wLot
Block Lot Area
Parcel No.
J
/�
0
3f2l77
222i/13
OCompany
Name
Contractor License No
Address
City/State
ZPhone
Supervisor Cert. No.
V
Electrical
License No.
W
Mechanical
License No.
Roofing
License No.
V
C" C WMEING
F
Framing
License No.
ZO
V
Plumbing
License No.
m
N
Concrete
License No.
TEAR OFF AND REROOF USING 21 SQUARES
As a condition for the issuance of a permit, 1 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 be me null nd void if the work authorized by such permit is not
commenced, suspended, abandoned or inspected within 180 days from the dat of suc ermit or m th, ate of the last inspection.
Print name of owner/agent Si re Date , TOTAL PEES $38