HomeMy WebLinkAbout4625 REGENCY DR - PERMITS - 4/6/2004Community Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
54=1
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 4625 REGENCY DR
PERMIT TYPE PERMIT
MECH Mechanical Alteration
Last Name, First, Middle Initial
oc WRAY, SAM AND STACY
w Address City/State
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3 4625 REGENCY DR FORT COLLINS, CO
0 Zip Phone No.
80526-3805 567-2158
BUILDING PERMIT
Building Valuation
B0401922 ACCOUNT
PERMIT DATE r� ,rL,
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0.11 U1it'tiiiy Perm' i1. W/G ,ciUkS
.EVEL CATEGORY TYPE
ISSU_FUL Residential
Construction Type flu
ccupancy Group
Wp No. of Stories ilding Height
OBuilding Square Footage I Stock Plan/Options
Front Setback Rear Setback
0
Z_ Right Side Setback Left Side Setback
Z
Plat File No. ZBA Case Number Zoning District
Subdivision/PU D Filing
J
Q
wLot Block Lot Area Parcel No.
0 9603105049
9� Company Name I Contractor License No.
Phone
City/State
License No.
jX
Mechanical
License No.
0
POUDPE VA«EY A,R
H. 835
IJ d
N
Roofing
License No.
Z
Framing
License No.
0
U
m
LO
Plumbing
License No.
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Concrete
License No.
ADD AC
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(See reverse side for Inspection Description)
GIL FNM
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.
FEE I DATE PAID
#15.0 4/6/04
Print name of owner/agent
ature
Date
TOTAL FEES
$15.