HomeMy WebLinkAbout416 S LOOMIS ST - PERMITS - 12/6/2004Community Planning &Environmental Services BUILDING P E RM I TPERMIT
Building &Inspections Division
FEES
�i 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
B0405672
ACCOUNT
FEE
DATE PAID
JOB SITE ADDRESSAi6
PERMIT DATE
5 WOMIS AVE
112/96/290-4
9Uiidl1g Permit u/ Subs
$43.2
12J6J04
PERMIT TYPE
PERMIT LEVEL
CATEGORY TYPE
Remodel
City Sales/Use 1 es/Use Tax
County Sales/Use Tax
$12 , 7
$ 3.4
12 / 6 / 0 4
12 / 6 / C 4
Z
O
Last Name, Firs , id a ni ial
8rtstruc ion Type
coupancy roup
Add
City/State
WQ No. of Stories
O
Building Height
ZIP
Phone No.FORT
Building Square Footage I Stock
Plan/Options
<i
Z
Right Side Setback Left Side Setback
• • •
Z
0
Plat File No. ZBA Case Number
Zoning District
(See reverse side for Inspection Description)
P RM [i L
_
Subdivision/PLID
Filing
Q
w
J
IN F N B F N E
Lot
Block
Lot Area
Parcel No.
F N P F N M S P I
UCP FR FP
OCompany
Name
Contractor License No.
0
SfRUCHON
ei
Add
City/State r
RE
F
?
Pho Supervisor Cert. No.
f eo
c1g:
Mechanical
License No.
R
H
Roofing
License No.
N
Z
Framing
License No.
U
m
Plumbing
License No.
h
Concrete
License No.
INSTALL EGRESS WINDOW IN BASEMENT
PERMIT FEE DOUBLED FOR WORK PRIOR TO PERMIT
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.
Print name of owner/agent
Date
TOTAL FEES