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HomeMy WebLinkAbout4625 REGENCY DR - PERMITS - 8/8/2003 (2)Community Planning &Environmental Services BUILDING PERMITPERMIT Building & Inspections Division FEES P.O. Box 580 281 N. College Ave. Building Valuation Fort Collins, CO 80522-0580 City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134 B 0 3 0 1 9 2 9 ACCOUNT FEE DATE PAID JOB SITE ADDRESS4625 REGENCY DR PERMIT DATE 08 08200 Ian Check Fee uilding Persit w/ Subs iby Sales/Ilse Tax $15.00 $60.08 W.00 7/30/03 8/8/03 8/8/03 PERMIT TYPE BSMNT Basement Finish -Residential PERMIT LEVEL ISSU_FUL CATEGORY TYPE Residential Remodel W Last Name, First, Middle Initial KNUTSON LORINGR/NANCYE Construction Type �N Occupancy Group Z 3 oality Sales/Use Tax $15. 20 8/8/03 Address City/State 4625 REGENCY DR FORT COLLINS, CO W p No. of Stories o Building Height Zip Phone No. 80526-3805 226-5164 Building Square Footage Stock Plan/Options Front Setback Rear Setback II c� Z_ Z • • • ffireverse Right Side Setback Left Side Setback Plat File No. ZBA Case Number Subdivision/PUD Zoning District Filing (See side For Inspection Description) R P n M J (D i d F h b F N F Lot Block Lot Area Parcel No. J 0 9603105049 Company Name Contractor License No. FNP FNM SPI u P F {� i P O n F Address City/State H ZZ Phone Supervisor Cert. No. V Electrical License No. (je Mechanical License No. H Roofing License No. License No. OFraming V co Plumbing License No. Concrete License No. BASEMENT FINISH FOR REC ROOM ONLY HOMEOWNER AFFIDAVIT ON FILE 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 co suspended, or inspected with' ' 180 days om the date of such permit or from the date of the last inspection. /e�ncred,/(abandoned name of ow er/agent Signature Date Print TOTAL FEES $147.28