HomeMy WebLinkAbout624 YARROW CIR - PERMITS - 2/10/2004Community Planning & Environmental Services
Building & Inspections Division BUILDING PERMIT
PERMIT
FEES
P.O. Box 580 281 N. College Ave.
Building Valuation
i Fort Collins, CO 80522-0580
City
of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 4 0 0 6 6
ACCOUNT
FEE
DATE PAID
PERMIT DATE
SITE ADDRESS c
JOB
PERMIT
624 AR. OW vIR
YARROW C .
TYPE
�UI�U ly PCrii11L M/ JIiUJ
$ 1
L��VJ US
PERMIT LEVEL CATEGORY TYPE+
!".RHTR !Hater Neater ISSU FUL Residential
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Last Name, First, Middle Initial Construction Type Occupancy Group
w
j
Address City/State O No. of Stories Building Height
>
YARROW
zip Phone No. V Building Square Footage Stock Plan/Options
80524482-6674
Front Setback Rear Setback
Z
Right Side Setback Left Side Setback
•
Z
Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
F M
J
Q
wLot
J
Block Lot Area Parcel No.
s !r
Q 9 7011417n
Name Contractor License No.
OCompany
V
Address City/State
Z
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Phone Supervisor Cert. No.
V
Electrical License No.
i T T I T IC CI PTnT ME 750
OMechanica
- License No.
H
n i TTI A AIR "All
URoofing
License No.
t—
OFraming
License No.
U
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Plumbing License No.
h
Concrete License No.
CONVERT FROM 40 GALLON LOW BOY TO A 40 GALLON ELECTRIC LOW BOY,
X
H
/
V
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 or from the ate of the last inspection.
r n t'f. JCP0rrn-L4�n� 2 --
name of owner/agent Si eature Date TOTAL
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FEES
15.0