HomeMy WebLinkAbout612 BALSAM LN - PERMITS - 4/6/1992DEVELOPMENT SERVICES/BUILDING PERMITS & INSPECTIONS DIVISION
SITE SETBACKS
P.O. BOX 580, FORT COLLINS, CO 80522-0580
221-6769
4
REAR
�a�rtyn D BUILDING PERMIT
JOB SITE ADDRESS
LEFT RIGHT
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Permit Type Work
Type Category Type
Cse"
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AI. CT DETACHED
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Po
Use nine Permit level
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Subdivision PUD FilingPERMIT
FEES
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Subdivision/PUD
Building valuation
419
FRONT
Lot
Block
Partial No.
ACCOUNT
FEE
DATE PAID
Last
First
M.I.
Lot Area
PAPVVTFU ESTATF-_-BEDS
PERMIT PLAT
15.00
920406
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CITY SAL£$ USE TA
0.00
920406PIatFuallo.
Address
city
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State
Zip
Phone No.
Off St Parking
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Company Name
Contractor License No.
REQUIRED INSPECTIONS
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CALL 221-6769
Address
City
State
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ET rm I TNq
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TO SCHEDULE INSPECTIONS
_ _ _
(See reverse side for
Zip
Phone
Sales Tax No.
An
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Inspection Description)
Consvuction ype -
Occupancy Graup
Fire Sprinkler
Building Square Footage
No. of Stones
Bldg, Height
TOTAL FEES
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FNP
ac
Occupant Load
Occupancy Separation
Area Separation
Fire Containment
3
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No. of Dwelling Units
No. of Bedrooms
No. of Bathrooms
Fireplace/Stoves
Basement
Stock Plan
Options
O
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Text:
WATER HEATER REPLACEMENT
to
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ZBA Case No.
BBA Case No.
•
Permit No. -
Permit Date
DEPARTMENT
STATUS
DATE
• c • '
AQ98ACIA A A
APPTI
OTC PEF
MIT IS6r.
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As a conditio fo the issuance of a permit, 1 hereby declare that I am an owner
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or the ownei agent, authorized to perform the proposed work on the property
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described herein. 1 agree to comply with all the requirements contained herein,
and City ordinances, and State laws associated with such work.I understand that
-
Mechanical
such permit may be revoked in the event that issuance was based on incorrect
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 such permit.
- -
Plumbing
Signature
Data
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