HomeMy WebLinkAbout4307 BLACK HAWK CIR - PERMITS - 11/21/2000ahCommunity Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
CityofF Phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 4307 BLACK HAWK CT
PERMIT TYPE GASLOG Gas Log - Gas Lighter PE
Last Name, First, Middle Initial
MONTOYA, RICHARD D, JR
Z Address City / State
3 4307 BLACK HANK CR FORT COLLINS, CO
Zip Phone No.
80526 201-0809
BUILDING PERMIT
Building Valuation
LEVEL ISSD-FUL
Constn
u No. of E
u
01
Z
Right Side Setback
Left Side Setback
Z
Plat File No.
ZBA Case Number
Zoning District
J
Subdivision/PUD
Filing
Q
wLot
Block
Lot Area
Parcel No.
J
0
9135327015
ceCompany
0
Name
Contractor License No.
FIREPLACE WEST III INC
FG-1381
Address
Ci state
'OR!
244 N COLLEGE AVE
I'llCOLLINS, CO 80524
Z
Phone
Supervisor Cert. No.
0
970-498-9679
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0
IJ
Z
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INSTALL GAS LOG FIREPLACE
No.
GL
B0017123 $500.00
AGCC)MT FEE DATE PANS;
PERMIT DATE 11/21/2000 Building Permit wife Subs $15.00 11/21/00
CATEGORY TYPE RESIDENTIAL ._ .._..
reverse
LG
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. I agree to comply with all 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 or incomplete information. This permit shall become null and void if the work authorized by such permit is not
commenced, suspended, abandoned or not inspected within 18 Sys from the date of such permit or from the date of the last inspection.
Print name of own uagent LI S nature Date