HomeMy WebLinkAbout1121 Saint Croix Pl - Permits/Water Heater - 12/04/2017�.F�o�rfCollins
Site Address: 1121 SAINT CROIX PL
Job Valuation: $1,215.00 Category: Residential
Owner: MEDEIROS DANIEL A
1121 SAINT CROIX PL
FORT COLLINS, CO 80525
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1708220
Issued Full: 12/04/2017
Permit Type: Residential Water Heater
Phone: 970-218-8877
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: Dec Group:
Fire Sprklr: Stock plan #:
Contractor: INDEPENDENT PLMBG SOL
1611 E Lincoln Ave Unit A
FORT COLLINS, CO 80524
Subcontractor(s)
Plumbing: INDEPENDENT PLMBG SOL
Work Description: Replace 50 gallon natural gas water heater.
Filing #: Lot #: Block #:
Ind sq ft: _
Const Type: _
Stock plan options:
License #: MP-610
Phone: 970-566-1377
Phone
970-566-1377
Basement sq ft:
Supervisor cert#:
License Number
MP-610
SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: hftp://www.fcgov.com/CitizenAccess
***By Mobile Device: http://www.fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 300 301 302
TOTAL FEES PAID AS OF 12/04/17: $52.34 Payment method: Check 1269
** 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: AII/ Q&2 3u_& Date: 12-il / 7
Form Revised Oct 2010
I}" O Community Deuelopment&Neighborhood Seruices
Fort Collins 281N. CollegeAue FortCollins, CO8o522
970.221.6�60 970.224.6i34 -fax
Building Permit#: B1708220
Issued Full: 12/04/2017
Permit Type: Residential Water Heater
Site Address: 1121 SAINT CROIX PL
Job Valuation: 1 215.00 Category: Residential
Transactions
Method Check Number Date Paid Amount Paid Comments
Check CK#1269 12/04/2017 $52.34 Independent Plumbing Solutions, Inc. paid by CK#1269
Receipt issued: 12/04/2017 Total Paid to Date: $52.34
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
City Sales/Use Tax 251.122030 $23.39 $23.39 12/04/2017 $0.00
County Sales/Use Tax 100.217030 $3.95 $3.95 12/04/2017 $0.00
Permit Flat Fee w/o Subs $25 1000.422010 $25.00 $25.00 12/04/2017 $0.00
TOTAL FEES: $52.34 $52.34 $0.00
TOTAL BALANCE DUE AS OF 12/04/2017: 0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Fortn Revised Oct 2010