HomeMy WebLinkAbout1636 Collindale Dr - Permits/Water Heater - 04/16/2012- City of
F"ort Collins
Site Address: 1636 COLLINDALE DR
Job Valuation: $1,125.00 Category: Residential
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.61S4 -fax
Building Permit #: B1200840
Issued Full: 04/16/2012
Permit Type: Residential Water Heater
Owner: JERNBERG DENISE M/ANSELL LOUISE M
1636 COLLINDALE DR
FORT COLLINS, CO 80525-2976
Phone:
Zoning: Front setback: Rear setback:
Right setback:
Left setback:
Minor Amend #: Plat File #:
ZBA Case #:
Zoning district: RL - LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PUD:
Filing #:
Lot #: Block #:
Code: Res sq ft: Com sq ft:
Ind sq ft:
Basement sq ft:
# of stories: Occ Group:
Const Type:
Fire Sprklr: Stock plan #:
Stock plan options:
Contractor: HAHN PLUMBING & HEATING
License #: MP-15
Supervisor cert #:
130 CHESTNUT ST
FORT COLLINS, CO 80524
Phone: 970-484-7668
Subcontractor(s)_
P
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! ( License Number.
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Plumbing: I �
HAHN PLUMBING & HEATING
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70 484 7668
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Work Description: REPLACE 50 GALLON WATER HEATER
I SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: http://amos.fcgov.com/CitizenAccess I
***By Mobile Device: http://amos.fcgov.com/CitizenAccess/amca/
Inspections: FNP FNE FNM
TOTAL FEES PAID AS OF 04/16/12: $25.00 Payment method: Trust Account
Fee Detall Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare that I am the owner or owners agent, authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein, and 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 information. This permit shall become null and void if the work authorized by such permit is not commenced,
suspended, abandoned or not inspected within 180 days from the date of such permit
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Signature: C( / Print Name: ,S%LC A Qr Date:
9 0 Form Revised Oct 2010
of
,,F�`ort_ Collins
Site Address: 1636 COLLINDALE DR
Job Valuation: $1,125.00 Category: Residential
Transactions
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1200840
Issued Full: 04/16/2012
Permit Type: Residential Water Heater
Trust Account 04/16/2012 $25.00 PAID BY HAHN TRUST ACCT
Receipt issued: 04/16/2012 Total Paid to Date: $25.00
Fee Description Account Code Fee Amount Amount Paid Date Paid
Permit Flat Fee w/o Subs $25 1000.422010 $25.00 $25.00 04/16/2012
TOTAL FEES:
$25.00 $25.00
TOTAL BALANCE DUE AS OF 04/16/2012:
r ..
Amount Due
$0.00
$0.00
0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010