HomeMy WebLinkAbout4318 KINGSBURY DR - PERMITS - 2/19/2004Community Planning & Environmental Services PERMIT FEES
Building & Inspections Division BUILDING PERMIT
P.O. Box 580 281 N. College Ave. Building Valuation
Fort Collins, CO 80522-0580
Mof Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 4
00753
FEE': DAMMD
JOB SITE ADDRESS PERMIT DATE
d318 KlNGSBURY DR Bui Idin P $15.0 2/19/04
PERMIT TYPE PERMIT LEVEL CATEGORY TYPE rj rt g I w/o Sl1hS
WTRHTR Water Heater ISSU FUL Residential
Last Name, First, Middle Initial Construction Type Occupancy Group
w
3 Address City/State O No. of Stories Building Height
0 Zip Phone No. V Building
1 g iii
Plan/Options
Front Setback Rear Setback .
Z Right Side Setback Left Side Setback
Z
Plat File No. ZBA Case Number Zoning District (See reverse side for Inspection Description)
Q Subdivision/PUD Filing f P
Lot Block Lot Area Parcel No.
8731316004
ixCompany Name Contractor License�No.
Address City/State
Z Phone Supervisor Cert. No.
V
Electrical License No.
OMechanical License No.
JAKE
Roofing NNEDY,
License No.
Framing License No.
0
cc Plumbing License No.
kN
Concrete License No.
REPLACE GAS WATER HEATER
As a condition for the issuance of a permit, 1 hereby declare that I am an owner or the owner's agent, authorized to perform the proposed work on the property
described herein. 1 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 f t e ate of the last inspection.
K0+erir16 eni _
Print name of ownerfagent Si natu a Dat— z/1
e I TOTAL FEES $16