HomeMy WebLinkAbout630 W OAK ST - PERMITS - 6/3/2004 (2)Community Planning & Environmental Services
Building & Inspections Division
P.O. 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 63o w oAK ST
PERMIT TYPE PEF
SPKLF-R Residential Sprinkler System
Last Name, First, Middle Initial
HADLOC3C FLORENCE M
Z Address City/State
3 630 W OAK ST I FORT COLLINS,
� Zip Phone No.
80521-2615 308-0716
BUILDING PERMIT
Building Valuation
60403528 ACCOUNT
PERMIT DATE
06/03/2004 Building Permit w/o Subs
LEVEL CATEGORY TYPE
ISSU_FUL Residential City Sales/Use Tax
Construction Type Occupancy Group
County Sales/Use Tax
Wp No. of Stories Building Height
0
Building Square Footage 7Stock Plan/Options
Front Setback
Rear Setback
0
Z
Right Side Setback
Left Side Setback
Z
Plat File No.
ZBA Case Number
Zoning District
Subdivision/PUD
Filing
J
Q
wLot
Block
Lot Area
Parcel No.
J
0
9711313014
OCompany
Name
Contractor License No.
F-
Address
City/State
H
Z
Phone I Supervisor Cert. No.
No.
Ine
Mechanical
License No.
0
Roofing
License No.
H
Z
Framing
License No.
V
m
Plumbing
License No.
V)
Concrete1
License No.
(See reverse side for Inspection Description)
SPK
INSTALL SPRINKLER SYSTEM
INSTALLED BY PLM, 409 ULA, FC 80524 308-0716
PROVIDE REQUIRED BACKFLOW DEVICE AND BACKFLOW TEST RESULTS CITY WATER
W
I—
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 date of the last inspection.
F,. L_ r V\^ vq" ��CJLJ� to� r! 3 rc-.->
Print name of owner/agent Signature Date
TOTAL FEES
FEE DATE PAID
$15.0 6/3/04
$16.5 6/3/04
$4.46/3/04