HomeMy WebLinkAbout419 W MOUNTAIN AVE - PERMITS - 1/20/2004Community Planning &Environmental Services BUILDING P E RM I TPERMIT FEES
Building & Inspections Division
i P.O. Box 580 281 N. College Ave. building Valuation
Fort Collins, CO 80522-0580
City of fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 4 0 0 2 8
ACCOUNT FEE DATE PAID
JOB SITE ADDRESS 419 W MOUNTAIN AVE #3 PERMIT DATE
C I /20/2004 3uildiiq Pernit w/o Subs $15.0 1/20/04
PERMIT TYPE PERMIT LEVEL CATEGORY TYPE
MECN Mechanical Alteration ISSU_FUL Residential
Last Name, First, Middle Initial Construction Type Occupancy Group
ad FROSETH BRUCE
LU
Z Address City/State in No. of Stories Building Height
3 524 SPRING CANYON CT FORT COLLINS CO 0
V
Q Zip Phone No. Building Square Footage Stock Plan/Options
80525 111
Front Setback
Rear Setback
0
Z_
Right Side Setback
Left Side Setback
Z
Plat File No.
ZBA Case Number
Zoning Di:
Subdivision/PU D
Filing
J
Q
LuLot
Block
Lot Area
Parcel No.
J
0
OCompany
Name
Contractor License No.
QAddress
City/State
dl—
Z
PhoneI
Supervisor Cert. No.
Electrical
License No.
Q'
Mechanical
License No.
OT
1 n A ITCC INC
H
Roofing
License No.
Z
Framing
License No.
0
V
m
Plumbing
License No.
V)
N
Concrete
License No.
REPLACE FURNACE
(See reverse side for Inspection Description)
CL F N M
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,
ab ndoned or inspected within 180 days from the date of such permit or from the date of the last inspection.
Print name of owner/agent
Signature
Date
TOTAL FEES
$15.