HomeMy WebLinkAbout419 W MOUNTAIN AVE - PERMITS - 5/10/2004Community Planning & Environmental Services
3wa ,e Building & Inspections Division
Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 419 W MOUNTAIN AVE
PERMITTYPE SFK�p R Residential Sprinkler System PERMIT
Last N����� Initial
me First le
fie leBRuCE Z Address City/State
3 524 SPRING CANYON CT FORT COLLINS, CO
O Zip W525 Phone No. 689-M4
BUILDING PERMIT
Building Valuation
B0402787
ACCOUNT
PERMIT DATE
05/ 10/2004 Building Pemit w/o Subs
_EVEL ISSu_FUL CATEGORY TYPE Residential
Construction Type I Occupancy Group
Q)
Z_ Right Side Setback Left Side Setback
Z
NPlat File No. ZBA Case Number Zoning District
Subdivision/PU D Filing
J
Q w Lot Block Lot Area O Parcel No. 97114119
15
J
Address City/State
Phone I Supervisor Cert. No.
W
Mechanical
License No.
Roofing
License No.
H
Z
Framing
License No.
v
m
Plumbing
License No.
Concrete
License No.
Wp I No. of Stories Building Height
O - - _
(See reverse side for Inspection Description)
SPK
INSTALL SPRINKLER SYSTEM
INSTALLED BY SPRINKLER MILL INC,161 E. SATURN DR #4, FC 223-4588 CCTY WATER PROVIDE
REQUIRED BACKFLOW DEVICE AND BACKFLOW TEST RESULTS (BACKFLOW DEVICE PREVIOUSLY
L INSTALLED)
MA
As a condition for the issuance of a permit, I hereby declare that I a wner or the owner's
described herein. I agree to comply with all City ordinances, and to associated w' su
event that issuance was based on incorrect or incomplete infor tion s per Tch
commenced, suspended, abandoned or inspected within 180 Wysf he to fp rS�f�PW `�JM,.
Print name of owner/agent
authorized to perform the proposed work on the property
6erstand that such permit may be revoked in the
d v d if the work authorized by such permit is not
t date of the last inspection. /
Date
1016
TOTAL FEES
$2,000.00
FEE DATE PAID
$15.0 5/10/04
$1