HomeMy WebLinkAbout430 GUILLEMONT ST - PERMITS - 11/14/2003Community Planning & Environmental Services
PERMIT FEES
Building & Inspections Division BUILDING P E RM I T
P.O. Box 580 281 N. College Ave.
Building valuation
Fort Collins, CO 80522-0580
city of Fort collies phone (970) 221-6760 Fax (970) 224-6134 B 0 3 0 7 1 1 5
29.99
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS 430 GUILLEMONT ST
PERMIT DATE
"! 11/ 1A/20Q3
9uilG'Mg Perrlit a/c Subs
$15.0
11/14/03
PERMIT
TYPE PERMIT LEVEL
WTRHTR Water Heater ISSU_FUL
CATEGORY TYPE
Residential
Ole
Last Name, First, Middle Initial
WALDEN,ESTHER
Construction Type
Occupancy Group
Z
3
Wp
O
Address City/State
430 GUILLEMONT ST FORT COLLINS, CO
No. of Stories
Building Height
O
Zip 80525 493-7696 Phone No.
U
Building Square Footage
Stock Plan/Options
Front Setback
Rear Setback
•
Z_
Z
• • • •
Right Side Setback Left Side Setback
Plat File No.
ZBA Case Number Zoning District
Subdivision/PLID Filing
(See reverse side for Inspection Description)
F N P
J
wLot
Block Lot Area Parcel No.
Q 97105412013
Name Contractor License No.
OCompany
V
Address City/State
H
Z
Phone Supervisor Cert. No.
U
Electrical License No.
O
Mechanical
License No.
t
14219
Roofing
License No.
H
Framing
License No.
ZO
U
�Plumbing
License No.
N
Concrete
License No.
REPLACE WATER HEATER
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 o from the date of the last inspection.
b&,ji ti o ", hn f! l463
name of owner/age t Signature 9 e Bate
Print
TOTAL FEES
$15