HomeMy WebLinkAbout403 Stout St - Permits/Backflow - 07/19/2017City of
F6rt,Collins
Site Address: 403 STOUT ST
Job Valuation: $150.00 Category: Residential
Owner: MATTEO THOMAS JOHN/SHUSHILA
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1703908
Issued Full: 07/19/2017
Permit Type: Residential Plumbing
403 STOUT ST
FORT COLLINS, CO 80524-0000 Phone:
Zoning: Front setback: Rear setback: 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: Occ Group:
Fire Sprklr: Stock plan #:
Filing #: Lot #: 1 Block #: 2
Ind sq ft: Basement sq ft:
Const Type:
Stock plan options:
Contractor: INDEPENDENT PLMBG SOL
1611 E Lincoln Ave Urii{ A" �F-, - C
FORT COLLINS', CO 805241
Subcontracto[is )_----j
Plumbing: INDEPENDENT PLMBVSOL
_V
Work Description: Installation of backflow preenter.
License #: MP-610
Phone: 970-566-1377
Supervisor cert #:
177 ❑
D
License Number
MP-610
ns
II SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: hftp://www.fcgov.com/CitizenAccess II
***By Mobile Device: http://www.fcgov.com/CitizenAccess/mobile
Inspections: RP GL UGP FNE FNM FNP
TOTAL FEES PAID AS OF 07/19/17: $28.38 Payment method: Credit Card 0472
*" 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 assodated 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: z Print Name: / � / Date:
Form Revised Oct 2010
City of
F6rt Collins
Site Address: 403 STOUT ST
Job Valuation: $150.00 Category: Residential
Transactions
Method Check Number Date Paid
Credit Card CK#0472 07/19/2017
Receipt issued: 07/19/2017 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
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: . B1703908
Issued Full: 07/19/2017
Permit Type: Residential Plumbing
Amount Paid Comments
$28.38 Tony Nolby paid with cc#0472
$28.38
Fee Amount Amount Paid Date Paid Amount Due
$25.00 $25.00 07/19/2017 $0.00
$2.89 $2.89 07/19/2017
$0.49 $0.49 07/19/2017
TOTAL FEES: $28.38
/1 DOTAL B
O
$28.38
$0.00
$0.00
$0.00
CE DUE AS -OF 07/19/2017: 0.00
00 �'� '� n
Fee Amounts are valid for date of this document only. Fees subject to change without notice.