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Home My WebLink About5209 Mill Stone Way - Permits/Reroof - 10/09/2014FfCollins Site Address: 5209 MILL STONE WAY Job Valuation: $2,300.00 Category: Residential Owner: KOZA RICHARD A/KRISTIN L 2100 S MAPLE CHADRON, NE 69337 Zoning: Front setback: Rear setback: ty Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.676o 970.224.6134 -fax Building Permit#: B1409676 Issued Full: 10/09/2014 Permit Type: Residential Roofing Phone: 308-432-4497 Right setback: Left setback: Minor Amend #: Plat File #: ZBA Case #: Zoning district: LMN -LOW DENSITY MIXED -USE NEIGHBORHOOD DISTRICT Legal: Subdivision/PUD: Code: Res sq ft: Com sq ft: # of stories: 2 Occ Group: Fire Sprklr: Stock plan #: Contractor: JERRYS ROOFING 115E2NDST LOVELAND, CO 80537 Filing #: Lot #: 11 Block #: 11 Ind sq ft: _ Const Type: Stock plan options: Basement sq ft: License #: R-1973 Supervisor cert#: Phone: 970-667-1269 Subcontractor(s),--] Phone Roofing: JERRYS ROOFING 97bL667-1269 O O Work DescrlptiOn: Tear off existing shingles to dec ventilation. Ice and water shield'required. Install perms License Number R-1973 with-23'squares of new shingles. Provide require wind specifications. Uses F&G Roofing. 2 story II SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: hftp://amos.fcgov.com/CitizenAccess II ***By Mobile Device: http://amos.fcgov.com/CitizenAccess/amca/ TOTAL FEES PAID AS OF 10/09/14: $127.68 Payment method: Check 3322 '* Fee Detail 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: Print Name: (ex W 7 Date: I C - - y Form Revised Oct 2010 F�o�rt Collins Site Address: 5209 MILL STONE WAY Job Valuation: $2,300.00 Category: Residential Transactions Check CK#3322 10/09/2014 Receipt issued: 10/09/2014 Total Paid to Date: Fee Description Account Code Building Permit Fee Without 1000.422010 Subs City Sales/Use Tax 251.122030 County Sales/Use Tax 100.217030 ty Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.676o 970.224.6134-fax Building Permit #: B1409676 Issued Full: 10/09/2014 Permit Type: Residential Roofing Amount Paid Comments $127.68 $127.68 Fee Amount Amount Paid Date Paid $76.50 $76.50 10/09/2014 $44.28 $44.28 10/09/2014 $6.90 $6.90 10/09/2014 TOTAL FEES: $127.68 t TOTAL B 0 1 $127.68 Amount Due $0.00 $0.00 $0.00 $0.00 ICE DUE AS OF 10/09/2014: 0.00 U I Fee Amounts are valid for date of this document only. Fees subject to change without notice.