HomeMy WebLinkAbout621 S WASHINGTON AVE - PERMITS - 1/27/2004Community Planning & Environmental Services
Building & Inspections Division
�- P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
City of Fort Collins ...one (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 621 S WASHING
PERMIT TYPE
MECH Mechanical Alteration
Last Name, First, Middle Initial
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W Address
Z City
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BUILDING PERMIT
=BO400407 Building Valuation
ACCOUNT
PERMIT DATE
Q 1 127 /rynr9 A
LEVEL ! ��u� Buliuirlg Permil16 w10 0 k
CATEGORY TYPE
Type
p� I:N. of StoriesOBuilding Height
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Building Square Footage I Stock Plan/Options
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Rear Setback
Z Right Side Setback Left Side Setback
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IV Plat File No. ZBA Case Number Zoning District ,
Subdivision/PUD (See reverse side for Inspection Description)
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Q Filing
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w Lot Block Lot Area
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d CompanRy Name 0 7 n
Contractor License No.
L) Address
City/State
License No
a� Mechanical
Q License No
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Roofing
License No
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O Framing
License No.
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Plumbing
License No.
Concrete
License No,
REPLACE FURNACE
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 da ch permit or from the date of the last inspection.
Print name of owner/agent Signa
Date TOTAL FEES
FEE DATE PAID
$iJ5,