HomeMy WebLinkAbout901 EDWARDS ST - SPECIAL INSPECTIONS - 12/10/2012Fort Collins
Address:
Date:
Fort Collins Building Services
281 N College Ave. PO Box 580
Fort Collins, CO 80522
970-221-6760 Phone 970-224-6134 Fax
970-221-6769 Building Services Inspection Line
PERMIT AND INSPECTION REQUEST FOR
EXISTING NON-STRUCTURAL CONSTRUCTION
Please print or type
I/we as owner(s) of record of
the aboveerty, I/ e heAy reque t a p rmit for the installation or construction of
work described in the following building permit application. Said work was completed
or covered without obtaining a permit and without required inspections at the time of
construction. I/we understand and agree that the City of Fort Collins Building Services
will perform a final inspection to assess compliance of such work with the current
building codes. Some or all of said work may be concealed by permanent
construction and finish materials. Based on observable conditions and nondestructive
methods, it may not be practical or possible for the City of Fort Collins to verify full
compliance with City building codes without removal of such permanent construction
and finish materials. I/we further understand that any violations of City Codes related to
health and safety associated with t e abo work or installation may require
correction.
Work performed by:
Name Address
Date work performed:��_�lTo
(Signat re): Date: U
*it
(Signature Date:
For office use only:
Permit/Application Number:
72 7?
Date applied: