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HomeMy WebLinkAbout912 PIONEER AVE - PERMITS - 1/22/2001Planning &Environmental Services BUILDING PERMITPERMIT FEES Building &Inspections Division ghCommunity P.O. Box 580 281 N. College Ave. Building Valuation Fort Collins, CO 80522-0580 $� 600.00 City of Fort Collins Phone (970) 221-6760 Fax (970) 224-6134 8ia1 JOB SITE ADDRESS 912 PIONEER AVE PERMIT DATE 01/22/2001 Building Permit w/o Sobs $15.0 1I22/01 PERMITTYPE GASLOG Gas Log - Gas Lighter PERMIT LEVEL ISSV—FUL CATEGORY TYPE RESIDENTIAL Last Name, First, Middle Initial HOLNQUIST- JOHNSON, HELEN Construction Type Occupancy Group Z 3 Address 912 PIONEER AVE City / Stat FORT COLLINS, CO p No. of Stories o U Building Height Zip80521-3523 Phone No. 493-2366 Building Square Footage StockPlan/Options Front Setback Rear Setback ! 01 • Z_ Right Side Setback Left Side Setback Z • 1 • Plat File No. ZBA Case Number Zoning District (See reverse side for Inspection Description) Subdivision/PUD Filing OL L0 Q J t, " at '• Lot BlockLot Area Parcel No. 9714209016 Name Contractor License No. OCompany Address City/State.: F Z Phone Supervisor Cert. No. V Electrical License No. ce oMechanical License No. Roofing License No. 0 Framing License No. co Plumbing License No. t=i> INSTALL GAS LINE AND GAS FIREPLACE INSERT INSTALLED BY HOMEOWNER - AFFIDAVIT ON FILE 57< As a condition for the issuance of a permit, 1 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 180 days from the date of suc mit or from the date of the last inspection. 'name of owner/agent Signature Dam Print