HomeMy WebLinkAbout3944 Celtic Ln - Special Inspections/Concealed Construction - 10/03/2016City of
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PERMIT AND INSPECTION REQUEST: FOR
EX.ISTING.NON-.STRU .NON -.STRUCTURAL CONSTRUCTION
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Address:
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Date: 0A
i/WE as,owner(s) of
record of the above, property, hereby request a permit for and final inspection of the.
installation or.constrtjctioniwork .described .in the following building permit
application, which work was completed.or covered. without obtaining a permit and
. without required inspections during construction. J/we understand and agree that
the City of Fort Collins Building &.Zo'ning 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 practicdl 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 ubderstand that any
violations of City Codes related to health and safety associated with the above work
or installation may require correction.
:,Work oerformed by:
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Name Address
Date. work performed:.
(Signature) Date 0h
z Ll (Signature) Date -3
For office use only.,
Permit/Application Number
Date applied:
00.