HomeMy WebLinkAbout919 W MOUNTAIN AVE - PERMITS - 7/19/2006r Community Planning &Environmental Services
Building & Inspections Division BUILDING P E RM I TPERMIT
FEES
P.O. Box 580 281 N. College Ave.
Building valuation
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134
urn nn
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
919 wmouNTAINky rm
lci
Building Permit w/o Sub
$15.
0 7/19/0
PERMIT
TYPE WTRHTR Water Heater
PERMIT LEVEL
CATEGORY TYPE
Last Name, First, Middle Initial
Construction Type
Occupancy Group
ce
w
'
Address City/State
O
No. of Stories
Building Height
>�
V
Zip
CO
Phone No.
Building Square Footage Stock Plan/Options
Front Setback
Rear Setback
Z_
Z
• • • •
Right Side Setback Left
Side Setback
Plat File No. ZBA Case Number
Subdivision/PUD
Zoning District
Filing
(See reverse side for Inspection Description)
f M P
Q
WLot
J
Block Lot Area Parcel No.
1 i Ann
Name Contractor License No.
OCompany
C-MR
P I H 142
Ij
Address
City/State
0
1 C 0
Phone Supervisor Cert. No.
V
Electrical License No.
OMechanical
License No.
Roofing
License No.
H
Framing
License No.
Z
V
�
Plumbing
License No.
rn
Concret
License No. '
REPLACE WATER HEATER
LU
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 inspected within 180 days from the date of such permit or from the date of the last inspection.
name of owner/agent Signature Date
Print
TOTAL FEES