HomeMy WebLinkAbout136 W Lake St - Permits/Electrical - 09/30/2011F6rt`A`YCollins
Site Address: 136 W_LAKE .ST
Job Valuation: $700.00, Category: Satellite Dsh/Teleaomm
Owner: CENTURY LINK
P.O. BOX 182575
COLUMBUS, OH 43218
Phone:
Development & Neighborhood Services
t N. College Ave Fort Collins, CO 8o522
97o.22i.676o 970.224.6134 -fax
Building Permit #: B1107966
Issued Full: 09/30/2011
it Type: Electric Service Change
Zoning: Front setback: Rear setback: Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: CC - COMMUNITY COMMERCIAL DISTRICT
Legal; Subdivision/PIJD:
Code: Res sq ft: 0 Com sq ft:
# of stories: Occ Group:
Fire Sprkir: Stock plan #:
Contractor: TRI-CITY ELECT,RiG::_I1, t-
813 EAST 18TH STREET #6'
GREELEY, COi80631
Subcontractor(sl 1 /
Electrical: TRI-CITY ELECTRIC_1,1,,'� L�
Job Contact:. OBERT'H-WAGNER.� "
U�
Work Description: INSTALL 100-AMP ELECTRIC SER
Filing #: Lot #: Block #:
Ind sq ft: Basement sq ft:
Const Type:
Stock plan options:
License #: ME-344 Supervisor oert #:
Phone: 970-352-5731
IF License Number
ME-344
TELEPHONE CABINET AS
SCHEDULE INSPECTIONS *** By Phone: 221-6769 1 By Web: http://amos.fcgov.com/CltlzenAccess **
Ins ections: FNE EG
TOTAL FEES PAID AS OF 09130/11: $15.00 . Payment method: Credit Card
"Fee Det`aD DftftW on Neat Page
As a =411lon for the issuance of a pertnR, I hereby declare that I am the owneror owners agent, auUror¢ed to perform the proposed work on the paperty desailmd herein.
I agree W comply with all the rewir mwits contained herein, and Qly ordnaimm and State laws associated with such work. I ur>darsfend that such pwM may be
revoked in the event that issuance was based on incorrect Information. This pemmit dig become nu0 arui vad if the wank authorized by such permit is rat commenced,
suspended, abandoned or not inspected within 180 days from the date of such parrnit.
Signature: Print Nam e� p Date: f l30 /R-p If
Form Revised Od 2010
`art Collins
/110�
Site Address: 136 W LAKE ST
Job Valuation: $700.00 Category: Satellite Dish/Telewrnm
Transactions
►zity Development & Neighborhood Services
28i N. College Ave Fort Collins, CO 8o522
97o.221.676o 97o.224.6134 -fax
Building Permit M B1107966
Issued Full: 09/30/2011
Permit Type: Electric Service Change
i
Credit Card 09/30/2011 $15.00 PAID BY ROBERT H WAGNER CC
Receipt Issued: 09/30/2011 Total Paid to Date: $15.00
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
Permit Flat Fee w/o Subs $15 1000.422010 $15.00 $15.00 09/3=011 $0.00
TOTAL FEES: $15.00 $15.00 $0.00
TOTAL BALANCE DUE AS OF 0913012011: 0.00
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Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010