HomeMy WebLinkAbout417 N ROOSEVELT AVE - PERMITS - 1/19/1994DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
0' P.O. BOX 580, FORT INS, CO 80522-0580
.AAVM221-671-6769
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LEFT RIGHT
JOB SITE ADDRESS
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Permit Type
Work Type Category Type
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a
Propose Use
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Use Zone Permit Leve
SubdivisionEl PUD
Filing
Subdivision/PUD
Building Valuation
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FRONT
Lot
Block
Parcel No.
ACCOUNT
FEE
DATE PAID
Last
First
M.I.
Lot Area
6LDG PERMIT FLAT
15.00
WAccess
CITY SALES USE TA
0.00
City
Plat File No.
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State
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Zip
Phone No.
Off St. Parking
¢
Company Name
Contractor License No.
INSPECTIONS
OREQUIRED
F
PRE VALLEY AIR
Address
city
State
O
Q
CALL 221-6769
A
TO SCHEDULE INSPECTIONS
0
Z11T
Phone
sales Tax No.
(See reverse side for
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Inspection Description)
Construction Type
Occupancy Group
Fire Sprinkler
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Building Square Footage
No. of Stories
Bldg. Height
TOTAL FEES
QU
6L
�FNM
Z—F i-
Occupant Load
Occupancy Separation
Area Separation
Fire Containment
3
-
-
�y
No. of Dwelling Units
No. of Bedrooms
No. of Bathrooms
Fireplace/Stoves
Basement
Stock Plan
Options
O
Z
O
Text
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FURNACE REPLACEMENT
a
0
•
•
ZBA Case No.
BBA Case No.
,
Permit No,
Permit Date
DEPARTMENT
STATUS
DATE
0940206
�
TC PER
IT IS.
Electrical
As a condition for the issuance of a permit, I hereby declare that I am an owner
or the owner's agent, authorized to perform the proposed work on the property
described herein. 1 agree to comply with all the requirements contained herein,
and City ordinances, and State laws associated with such work.I understand that
Mechanical
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.
Plumbing
Signature
Date
ORIGINAL - FILE. BLUE - OFFICE, CANARY - SALESTAX, PINK - APPLICANT, TAG - FIELD CARD