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HomeMy WebLinkAbout1318 Coulter St - Permits/Other - 09/26/2005Community Planning &Environmental Services Building & Inspections Division BUILDING PERMIT imP.O. Box 580 281 N. College Ave. Building Valuation Fort Collins, CO 80522-0580 CiiyofFort Collins phone (970) 221-6760 Fax (970) 224-6134 B0505611 ACCOUNT JOB SITE ADDRESS 1318 COULTER ST PERMIT DATE n r 09/26/�OOJ Building Permit PERMIT TYPE PERMIT LEVEL CATEGORY TYPE FIREPL Fire Place - Wood Stove ISSU_FUL Residential; City Sales/Use T Last Name First Middle Initial Construction Type Occupancy Group W EI,"rate i`NACHILLJ JARED P Address City/State 1318 COULTER ST FORT COLLINS, CO 0 Zip 80524 Phone No. 443-0679 Z Right Side ; Z Plat File No. Phone ce mecnamc 0 Roofing F Z Framing U co Rear Setback Left Side Setback Number Lot Area Contractor Licen: City/State tr Cert. No. License No. License No. License No. Zoning District Parceo. 0 l N9701130015 p No. of Stories 0 Building Square (See reverse SPI Plan/Options x Inspection Description) FP =5 Plumbing License No. N Concrete License No. INSTALL NEW WOODBURNING INSERT INTO EXISTING WOODBURNING FIREPLACE. EPA RATED REGENCY HAMPTON (FPI) H1301. RELINE EXISTING METAL CHIMNEY WITH 6° STAINLESS FLEXIBLE TUBING HOMEOWNERAFFIDAVIT ON FILE 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 o such permit or from the date of the last inspection. Print name of owner/agent ature Of Date $1,669.00 w/o Subs $15,0 9/26/05 ax 1 $25.0 9/26/05' County Sales/Use Tax $6.6 9/26/05