HomeMy WebLinkAbout919 BITTERBRUSH LN - PERMITS - 12/15/2004Community Planning & Environmental Services
BUILDING PERMIT
Building & Inspections Division
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
B0407509
ACCOUNT
FEf
UYIND
JOB
SITE ADDRESS
PERMIT DATE
gig
12/15/2004
Building Permit w/o Subs
$15.0(
12/15/04
PERMIT
TYPE
PERMIT LEVEL
CATEGORY TYPE
Log - Gas lighter
City Sales/Use Tax
$15.0
12/15/04
Last Name, Firs , i e ni ial
dRstrucflon Type
Occupancy Group
Z
Building Permit. w/o Subs
$15.
12/15/04
Add e
City/State
p No. of Stories
Building Height
3
FORT CO
County Sales/Use Tax
$4.0
12/15/04
Zip
Phone No.
U
019-7363
Building Square Footage Stock Plan/Options
Front a ac Rear Setback
Right Side Setback Left Side Setback
• • •
Z_
Z
N
1
Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
OL LO
J
a
wLot
J
Block Lot Area Parcel No.
Name Contractor License No.
OCompany
QAddress
City/State
Z
O
Phone Supervisor Cert. No.
V
Electrical License No.
oc
Mechanical
License No.
Roofing
Framing
License No.
License No.
H
Z
V
m
Plumbing
License No.
N
Concrete
License No.
HOMEOWNER INSTALLED GAS LOG FIREPLACE IN GARAGE ADDITION FOR USE IN FAMILY ROOM.
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 erstand that such permit may be revoked in the
event
that issuance was based on incorrect or incomplete information. Thi tt hall beco an oid if the work authorized by such permit is not
commenced,
suspended, abandoned or inspected within 180 days fr he dat of suc f the date of the last inspection.
name of owner/agent Si a Date c +
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TOTAL FEES