HomeMy WebLinkAbout6244 WESTCHASE RD - PERMITS - 1/14/2004Planning &Environmental Services BUILDING PERMIT
PERMIT
FEES
Building & Inspections Division
Building Valuation
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6aCommunity
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
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City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 4 0 01 4
ACCOUNT
FEE
DATE PAID
$15,C
1/14/C4
PERMIT DATE
SITE ADDRESS 6244 WESTCHASE RD u 1 ''l� 2UU + Building Fermii w/o Subs
JOB
TYPE PERMIT LEVEL CATEGORY TYPE
Residential Sprinkler System ISSU FUL Residential
PERMIT
SPKLR-R
Last Name, First, Middle Initial Construction Type Occupancy Group
LU
w No. of Stories Building Height
Address City/State O
Z
3MICHAEL
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HQl 7 81 On F MAPLEWOOD # V Building Square Footage Stock Plan/Options
Zip Phone No.
80111 303-486-5000
Front Setback !
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Right Side Setback 7LeftSide;Setba;ck
Z
0
ZBA Case Number Zoning District (See reverse side for Inspection Description)
Plat File No.
Subdivision/PLID Filing S I' K
J
(02
Lot Block Lot Area Parcel No.
J
O
Name Contractor License No.
OCompany
H
a
Address City/State
dZ
Phone Supervisor Cert. No.
V
Electrical License No.
Ce
Mechanical License No.
O
Roofing License No.
Z
Framing License No.
O
j
Plumbing License No.
U)
M P 43,
Concre a License No.
INSTALL SPRINKLER SYSTEM - PROVIDE REQUIRED BACKFLOW DEVICE AND BACKFLOWN TEST
RESULTS FCB D
LU
W
V
As 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 issuanco was based on incorrect or incomplete information. This permit shall become null and void if the work authorized by such permit is not
commenced, su pen d, abandoned or inspected within 180 days from the date of such permit or from the date of the last inspection.
TOTAL FEES
$15.06
Print name of owner/agent Signature Date