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City
Of Community Development & Neighborhood Services
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28s N. College Ave Fort Collins, CO 80522
Fort Collins 970.221.6760 970.224.6134 -fax
Building Permit #: B1601265
Issued Full: 03/24/2016
ii Permit Type: Residential Mechanical
i Site Address: 3615 ROCKY STREAM DR
Job Valuation: $4,147.00 Category: Residential
Owner: CREWS KENT/KERI
3615 ROCKY STREAM DR
FORT COLLINS, CO 80528 Phone: 970-282-1769
Zoning: Front setback: Rear setback: Right setback: Left setback:
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E
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: UE - URBAN ESTATE DISTRICT
I i Legal: Subdivision/PUD: Filing #: Lot #: 48 Block #.
.I Code: Res sq ft: Com sq ft:
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# of stories: Occ Group:
j Fire Sprklr: Stock plan #:
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j Contractor: FORT COLLINS HEATING & AIR
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208 COMMERCE DR#4
FORT COLLINS, CO 80524
Subcontractor(s)
Mechanical: FORT COLLINS HEATING & AIR
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Work Description: Install furnace.
Ind sq ft:
Const Type:
Stock plan options:
Basement sq ft:
License #: H-1309 Supervisor cert#:
Phone: 970-484-4552
Phone License Number
970-484-4552 H-1309
I SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: http://www.fcgov.com/CitizenAccess I
***By Mobile Device: http://www.fcgov.com/CitizenAccess/mobile
Inspections: GL FNM FNP FNE III
TOTAL FEES PAID AS OF 03/24/16: $118.31 Payment method: Trust Account
** 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:
Date:
Form Revised Oct 2010
City of Community Development & Neighborhood Services
F_ 281 N. College Ave Fort Collins, CO 80522
ort Collins 970.221.6760 970.224.61S4 -fax
Building Permit #: B1601265
{ Issued Full: 03/24/2016
r Permit Type: Residential Mechanical
Site Address: 3615 ROCKY STREAM DR
Job Valuation: $4,147.00 Category: Residential
Method Check Number Date Paid Amount Paid Comments
Trust Account 03/24/2016 $118.31
Receipt issued: 03/24/2016 Total Paid to Date: $118.31
Fee Description Account Code Fee Amount Amount Paid
City. Sales/Use Tax 251.122030 $79.83 $79.83
County Sales/Use Tax 100.217030 $13.48 $13.48
Permit Flat Fee w/o Subs $25 1000.422010 $25.00 $25.00
TOTAL FEES
$118.31 $118.31
Date Paid
Amount Due
03/24/2016
$0.00
03/24/2016
$0.00
03/24/2016
$0.00
$0.00
0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.