HomeMy WebLinkAbout4900 S SHIELDS ST - PERMITS - 5/13/1992SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
01
SDEVELOPMENT
7. P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769
REAR
City of ours BUILDING PERMIT
LEFT RIGHT
JOB SITE ADDRESS-
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Permit Type
Work Type
Category Type
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Proposed Use
Use Zone
Permit Level
Subdivision PUD EPERMIT
FEES
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Subdivision/PUD
Building Valuation _
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FRONT
Lot
Block
Parcel No.
ACCOUNT..
FEE
D TE PAID
Last .. ,- _ _
First _
M I.
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Lot Area
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Address."...._.._._
City
at File No.
State
Zip
Phone No.
Off Si. Parking
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Company Name
Contractor License No-
REQUIRED INSPECTIONS
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_
CALL 221-6769
Address
City _
State -
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-- -
TO SCHEDULE INSPECTIONS
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(See reverse side for
zip
Ph
sales Tax No
I
- - _
=- - - _ -
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Inspection Description)
Construction Type
Occupancy Group
Fire Sprinkler
Building Square Footage
No. of Stories
Bldg. Height
TOTAL FEES
= -
-
Occupant Load
Occupancy Separation
Area Separation
Fire Containment
3
ry
No. of Dwelling Units
No. of Bedrooms
No. of Bathrooms
Fireplace/Stoves
Basement
Stock Plan
Options
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TR.
MY
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Text:. _._ ._. _... _. ._ _.
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ZBA Case No.
BRA Case No.
Permit No
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--
Permit Date
T
DEPARTMENT
STATUS
DATE
• .
, •
As a conditio fof the issuance of a permit, I hereby declare that I am an owner
= -1 -
Tee
- ` - - -
Electrical
or the owne 's agent, authorized to perform the proposed work on the property
described herein. 1 agree to comply with all the requirements contained herein,
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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 p rmit is not comm d, suspended, abandoned, or not inspected within
180 s from the clat fs ch permit.
Plumbing
Signature
— VVAq, I
Dat
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ORIGINAL - FILE, BLUE - OFFICE, CANARY - SALE§fIAX, PINK - APPLICANT, IAG - FIELD GARD