HomeMy WebLinkAbout416 N ROOSEVELT AVE - PERMITS - 10/4/2004Community 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
OB SITE ADDRESS 416 N ROOSEVELT AVE
RMIT TYPE
SPKLR-R Residential Sprinkler System PERT
Last Name Frst Middle Initial
Cie
ntE► t vN, .DAMES T/ARUNE H
Z
Address
3
City/State
416 N ROOSEVELT AVE
O
Zip FORT COLLI
Phone No.
80521-1646
482-9583
Front Setback Rear Setback
c�
Z_
Z
Right Side Setback
Left Side Setback
Plat File No.
ZBA Case Number Zoning District
Subdivision/PUD
Q
Filing
wLot
J
Block Lot Area Parcel No.
W
Company Name
License No.
CContractor
Address City/State
H
Z
Phone Supervisor Cert. No.
V
Electrical
License No.
O
Mechanical
License No.
H
Roofing
License No.
H
Z
Framing
License No.
V
�
N
Plumbing
CASS PLUMBING 8 HEATING
License No.
MP 292
Concrete
License No.
el
BUILDING PERMIT
Building Valuation
I F 7
L70106I 9J
ACCOUNT
HCAT-EGORY
RMIT DATE
10/04/2004 Building Permit w/o Subs
EVEL TYPE
ISSU_FUResidential
Construction Type Occupancy Group
Ow No. of Stories
Building Height
V
Building Square Footage Stock Plan/Options
(See reverse side for Inspection Description)
SPK
RESIDENTIAL SPRINKLER BEING INSTALLED BY WATERBOY SPRINKLERS 1216 N SHIELDS ST FTC, CO
80524
PROVIDE REQ-D BACKFLOW PREVENTER AND TEST RESULTS
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 DATE PAID
$15.00 10/4/04
Print name of owner/agent Signature TOTAL FEES
Date $15