HomeMy WebLinkAbout4703 Prairie Vista Dr - Permits/Gas - Log, Line, Pipe - 04/06/2015F6rt Collins
Site Address: 4703 PRAIRIE VISTA DR
Job Valuation: $5,500.00 Category: Residential
Owner: SAVAGE ANNETTE M
4703 PRAIRIE VISTA DR
FORT COLLINS, CO 80526
Zoning: Front setback:
Rear setback:
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
97o.22i.676o 970.224.6134 -.fax
Building Permit#: B1502217
Issued Full: 04/06/2015
Permit Type: Residential Gas Log
Phone: 303-916-5999
Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: LMN -LOW DENSITY MIXED -USE NEIGHBORHOOD DISTRICT
Legal: Subdivision/PUD:
Filing #: Lot #: 1 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: KEM HOMES CONSTRUCTION, INC. License #: C2-24 Supervisor cert#:
7352 GREENRIDGE ROAD_A-6 , ,
WINDSOR, CO 80550 . , I I Phone: 970-663-9430
Subcontractors) ail ''- .Phone ! License Number
Lj
Work Description: Install gas fireplace..in-walkout
basement bathroom - Kingsmari•Marquis Serenity:
sman Bentley 39 ZCV39 and 1 gas
at the same time.
SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: http://www.fcgov.com/CitizenAccess
***By Mobile Device: http://www.fcgov.com/CitizenAccess/mobile
Inspections: LG GL
TOTAL FEES PAID AS OF 04/06/15: $148.75 Payment method: Credit Card 2730
*' Fee Detail Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare that I am the owner or owner's 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: Date: V /44/jt4�
Form Revised Oct 2010
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t Collins
Site Address: 4703 PRAIRIE VISTA DR
Job Valuation: $5,500.00 Category: Residential
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit#: B1502217
Issued Full: 04/06/2015
Permit Type: Residential Gas Log
Transactions
Method Check Number Date Paid Amount Paid Comments
Credit Card CK#2730 04/06/2015 $148.75 William Gurski CC
Receipt issued: 04/06/2015 Total Paid to Date: $148.75
Fee Description Account Code Fee Amount Amount Paid
City Sales/Use Tax 251.122030 $105.87 $105.87
County Sales/Use Tax 100.217030 $17.88 $17.88
Permit Flat Fee w/o Subs $25 1000.422010 $25.00 $25.00
TOTAL FEES:
$148.75 $148.75
Date Paid
Amount Due
04/06/2015
$0.00
04/06/2015
$0.00
04/06/2015
$0.00
$0.00
TOTAL BALANCE DUE AS OF 04/06/2015: 0.00
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Fee Amounts are valid for date of this document only. Fees subject to change without notice.