HomeMy WebLinkAbout918 BOLTZ DR - PERMITS - 6/29/1981CITY OF FORT COLLINS
APPLICATION FOR BUILDING PERMIT —SHORT FORM
Building Address iS d) S
Date of Application TU yvC oZ 19 0 Y
Name
3
Mail Address
O
City Tel. No.
o
Name xrv�%Tl a c`t7
m
Address Qa i4ioCC*S+ N C,r
c
CityloarTr
U
City License No.54M7 Tel. No.a�Q-(87S
Occupancy Group A, B, C, D, E, F, G,
H, 1, J Division 1, 2, 3, 4
Use Zone —RE, RL, RLM, RM, RH, RP, RMP
ML, MM, BP, BL, HB, BG, C, IL, IG
Fire Zone 1, 2, 3
PUD
Signature of owner
By Contractor "d ¢,,A Iv.,.�
U
Class of Work
Plumbing
_Roofing _
Heating
_Fencing _
Electric
_Sprink. _
Gas Pipe
_Storm W_
Sign
_Other _
Permit No.
a . �0
VALUE
/ 2S n
I nt. lot
Value Labor & Mat. I Corner lot
7J' !-o 00
Description of Work
,i)r CieA�rarcc4z -
Pi1)e
M-77 c.
M � C_36
DgtM itsVgg6I
Bldg. fee
�3 �a
Other
TotalI
Rev. C. L.
Street
Approved for Chief B.I.
Zoning
a
µTr[9-CrtY GI¢h
Rnx - 8"a' G lnspeclor
Ye1Ww-AOpllcapl
ream � auspense
City of Fort Collins, Colorado
Date
Estimated Cost of
Labor and Material�-
+9
Permit Fee
• r`
Plan Check Fee
Work In
Progress Fee
rr
V (Y7
TOTAL DUE '7
Description of Authorized Work i A!_L
Special
Conditions of ISsuan of
R17 75 IIt r� ,it't
e�12
BUILDING PERMIT NO. rt,
is hereby authorized to:
(name)
❑ Enlarge ❑ Erect ❑ Repair ❑ Remodel ❑ Demolish ❑ Move
Structure At
ADDRESS 9Ae,
Legal Description: Lot Block Subdivision
Occ Group Consl. Type Zone
J r-
o
CONTRACTOR'S STATEMENT: As the duly licensed contractor5for the above work', 11 understand the limitations of said Iicens and 0 all
responsibility for the work authorized hereunder and further acknowledge that fraudulent use or lending of such license to obtain P. its for Sher
contractor actually performing the work, may be cause for revocation "and other penalties. (Sec. 73-124 Municipal Gode)
N (Lii y y t r
�' (Contractors - ! t_. c. oJ '(Signature of Authorized Agent)
This permit is issued on the express condition that the a a
work hereby authorized shall in all respects conform to
the statements certified in the application for such `Y/
permit and that all work shall be done in accordance with W IIIId1Yl E.7 W il(�C� _ a
theordinancesof the City of Fort Collins and the laws of Chief DZiddlnhlofficial�...�
the State of Colorado. The granting of this permit does t -
not give the authority, to violate any of these regulations. PERMIT -BECOMES VOID IF AUTHORIZED WORK IS NOT COMMENCED WITHIN 180 DAYS
r._