HomeMy WebLinkAbout416 N LOOMIS AVE - PERMITS - 9/24/2004%,-V1><,u,<,<u,<><,«y r,<a„<t,11,<r, EXAM BUILDING PERMIT
Building & Inspections Division
P.O. am
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 B0406038
ACCOUNT
JOB SITE ADDRESS 416 N LOOMIS AVE PERMIT DATE 09/24/2004 Building Permit w/o Subs
PERMIT TYPE PERMIT LEVEL CATEGORY TYPE
ROOF Roofing - ReRoafing ISSU_FUL Residential City Sal/lice Tax
Last Name, First, Middle Initial Construction Type Occupancy Group
COLEMAN MS County Sales/Use Tax
Z Address City/State p No. of Stories Building Height
3 416 N LOOMIS AVE FORT COLUNS, CO
O
U Zip Phone No. Building Square Footage Stock Plan/Options
80521 221-7134
Front Setback Rear Setback
2 Right Side Setback Lett Side Setback
Z
2 Plat File No. ZBA Case Number Zoning District (See reverse side
Subdivision/PUD Filing R p0
J
Q
wLot Block Lot Area Parcel No.
0 97119111M
4—
Phone
Supervisor Gert. No.
0
970 484 7777
Electrical
License No.
oC
Mechanical
License No.
Roofing
License No.
Framing
License No.
U
m
Plumbing
License No.
H
Concrete
License No.
REMOVE AND REPLACE 17 SQAURES - TAX BASED ON $ 680.00 MATERIALS.
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.
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Print name of owner/agent ignature Date
28.00 9/24/04 1
$3.01 9/24/04 1