HomeMy WebLinkAbout4702 SNOW MESA DR - PERMITS - 1/18/2005 (2)9hCommunity Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
29of r4m Collins Phone (970) 221-6760 Fax (970) 224-6134
SITE ADDRESS
PERMIT LEVEL
City/State
Right Side Setback Left Side Setback
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2 Plat File No. ZBA Case Number
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Lot
Block
Lot Area
Parcel No.
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Company Name
Contractor License No.
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City/State
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License No.
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License No.
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Framing
License No.
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Plumbing
PLUMBING
License No.
ConPORATE
License No.
TENANT FINISH - FOR POUDRE VALLEY INTERNISTS
METAL STUD AND GYP BOARD WALLS, LAY IN CEILING AND FlNISHES
OWNER AUTHORIZATION ON MLE
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 Signature Date
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