HomeMy WebLinkAbout928 W LAKE ST - PERMITS - 7/26/20060„ Community Planning &Environmental Services
PERMIT FEES
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s. Building & Inspections Division �� I
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 B 0 6 0 3 6 0 2
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS
PERMIT DATE
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Sliliding Permit w/o Sub
$15.
0 7/26/O
PERMITTYPE
PERMIT LEVEL
CATEGORY TYPE
Last Name, First, Middle Initial
tl
Construction Type Occupancy Group
I
Z
PE HARRY
Address City/State
O
No. of Stories
Building Height
ZipV
Phone
No.
Building Square Footage Stock Plan/Options
Front Setback Rear
Setback
fi •
_Z
• • • •
Right Side Setback Left
Side Setback
2
Plat File No.
ZBA Case Number
Zoning District
(See reverse side for Inspection Description)
FMP
Q
Subdivision/PUD
Filing
wLot
Block
Lot Area
Parcel No.
0
OCompany
Name
Contractor License No.
MR 4
Address
City/State
H
Z
1
UPI COLLA, Go S
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Phone
Supervisor Cert. No.
V
07n
Electrical
License No.
O
Mechanical
License No.
F
URoofing
H
License No.
Z
Framing
License No.
V
50
Plumbing
License No.
t�
Concre
License No.
INSTALL WATER HEATER
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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.
Print name of owner/agent
Date
TOTAL FEES