HomeMy WebLinkAbout654 MANSFIELD DR - PERMITS - 3/30/2004Community Planning &Environmental Services BUILDING PERMIT
Building & Inspections Division
P.O. Box 580 281 N. College Ave. Building Valuation
Fort Collins, CO 80522-0580�.�
c�ev of Fod Collins Phone (970) 221-6760 Fax (970) 224-6134 E 0 4 017 21 '
ACCOUNT FEE DATE PAID
JOB SITE ADDRESS 654 MANSFIELDDR PERMIT DATE 03/30/2004 Building Permit a/o Subs i30.0 3/30/04
PERMIT TYPE PERMIT LEVEL CATEGORY TYPE
MECH Mechanical Alteration ISSU_FUL Residential ;
Last Name, First, Middle Initial Construction Type Occupancy Group
DUDEK, BRIAWNICOLE _
Z Address City/State p No. of Stories Building Height
654 MANSFIELD DR FORT COLLINS, CO
3 O
Zip 80525 Phone No. 481 U-5235 Building Square Footage Stock Plan/Options
Front Setback Rear Setback ! ,
Right Side Setback Left Side Setback
Z
2 Plat File No. ZBA Case Number Zoning District (See reverse side for Inspection Description)
Subdivision/PUD Filing 0 i. F N M
9 Lat Block Lot Area Parcel No.
9125412169
OCompany Name Contractor License No.
G
Address
City/State
Phone
Supervisor Cert. No.
V
Electrical
License No.
Mechanical VALLEY
A Y A
License No.POUDRE iI 835
Roofing
License No.
Framing
License No.
V
Plumbing
License No.
cn
rn
Concrete
License No.
FURNACE REPLACEMENT AND AIR CONDITIONER REPLACEMENT
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 date of the last inspection.
Print name of owner/agent
Date
FEES I S.