HomeMy WebLinkAbout3520 Riva Ridge Dr - Special Inspections/Concealed Construction - 02/28/2011�:4 � � �,: - 7���, _tCommunit�r Planning and Environmental Ser�ices
-.4, ,.���� +�y;�; ;Building an Zoning Department
F� PERMIT AND INSPECTION REQUEST FOR
x -- EXISTING NON-STRUCTURAL CONSTRUCTION
"l S , iktrvw f 1 4 t}rf
Ffecsp pr6; or type
Address: `t i2���+c�.� l apt. r� c �llrh� cep pc,°s W
Date: -2g
! I/WE S P-506On- as owner(s) of
record of the above property, hereby request a permit for and final inspection of the
installation or construction work described in the following building permit
application, which work was completed or covered without obtaining a permit and
without ?equired inspections during construction. I/we understand and agree that
the City of Fort Collins Building & Zoning Department will perform a final inspection to
assess compliance of such work, some or all of which may be concealed by
permanent construction and finish materials, based on observable conditions and
nondestructive methods: and, that it may not be practical or possible for the City of
Fort Collins to verify full compliance with City building codes without removal of such
permanent construction and finish materials. I/we further understand that any
violations.of City Codes related to health and safety associated with the above work
or installation may require correction.
Work performed by: i{ k J w �
Nome Address
Date work performed: "(5 �` ► ��o�fL wl r� �, �- -!
(Signature)Date �/"j It
(Signature)
For office use only:
Permit/Application Number
Date applied:
Date
Sl North Collea,e Avenue - PO. Box 580 • Fort Collins, CO S05-1 -0-580 • (97M 221-6'60 • FAX (970) 2'_4-61 ,-4
Scott Pearson, M.S., D.V.M.
1933 Stuart St. Apt E
Berkeley, CA 94703
Tel. 510-705-1785
spearsondvm@mac.com
http://www.iident.com/scottpearson/
ATT00001.txt 1
Page 1