HomeMy WebLinkAbout636 Rocky Mountain Way - Permits/Water Heater - 05/14/1991DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
P.O. BOX 580, FORT COLLINS, CO 80522 0580
221-6769
REAR
tiro n o S BUILDING PERMIT
LEFT RIGHT
JOB SITE ADDRESS
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Parprit TVP�N.4r1
, Type Cateypry Typa
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P+{xKed Use
Use Zone Perwit�level
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SubdivisionLl PUD
FilingPERMIT
FEES
Building valuation
QSubdivision/POD
C9
FRONT
Lot
Block
Parcel No.
ACCOUNT
FEE
DATE PAID
L," -
First
M.I.
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-
Lot Area
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Address ,-;
City
Plat File No.
Phone.No,, ,_
Off St. Parking
C,ompany Nand -. .. - - 1
Contractor L"�_ense No.
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REQUIRED INSPECTIONS
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CALL221-6769
Adpas i,
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State
TO SCHEDULE INSPECTIONS
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o
(See reverse side for
Zip Phone - Sales T04-Np. ;
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Construction Type Occupancy Group Fire Sprinkler
Inspection Description)
'
Building Square Footage
No. of Stories
Bldg. Height
TOTAL FEES
15 ..0,0
Occupant Load
Occupancy Separation
Area Separation
Fire Containment
O
3
No. of Dwelling Units
No. of Bedrooms
Fireplace/Stoves
Basement
Stock Plan
Options
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on
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,
ZBA
Case No.
No_„_, . - .-.
_.cc�DEPARTMENT
BBA Case No.
Par tee,
•
Permit
STATUS
SUB
CONTRACTORS
As a condition for the issuance of a permit, I hereby declare that I aman
owner or the owner's agent, authorized to perform the proposed
]::al
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.
Plumbing
Signature
Date
IRIGINAL - FILE, BLUE - OFFICE, CANARY - SALESTAX, PINK - APPLICANT, TAG - FIELD CARD