HomeMy WebLinkAbout925 COLUMBIA RD - PERMITS - 1/3/1992DEVELOPMENT SERVICES/BUILDING PERMITS'& INSPECTIONS DIVISION
P.O. BOX 580, FORT COLLINS, CO 180522-0580
MEMO 221-6769
4"� 1
BUILDING PERMIT
JOB SITE ADDRESS
F Permit Type
Nfork yPe Category Type
WATrR HEATER
Q. Proposed Use Q.Use Zone Permit Level
Subdivision I I PUD
J
u
J
1 I Z
¢ Occupant Load -
O
3
tL No. of Dwelling Umis - Nc
O
Z
O Text'
NEW WATER HEATER
vein
Filing
ACCOUNT FEE DATE PAID
MI.
- BLDG_.P_ERMI-T_FLAT__ __ _. __ .15.. 00_. _ _92010
city CITY SALES USE TA 0.00 92010
FORT 17011 INS
Contractor License No.
City State
Sales Tax No.
Permit No.(Permit Date
Separation
As a conditioM f6r the issuance of a permit, I hereby declare that I am an owner
or the owners agent, authorized to perform the proposed work.on the property
described herein. 1 agree to comply with all the requirements contained herein,
and 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
information. This permit shall become null and void if the work authorized by
such permit is not commenced, suspended, abandoned, or not inspected within
180 days from the date of such permit. "-
TOTAL FEES
QTF QFTRAr KS
SITE SETBACKS
REAR
LEFT
FRONT
Plat File No.
off St Parking
RIGHT
CALL 221-6769
TO SCHEDULE INSPECTIONS
(See reverse side for
Inspection Description)
i
DEPARTMENT STATUS DATE
OTC PE MIT ISS Electrical
Mechanica
.Plumbing
Signature - I Date
APPLICANT, TAG - FIELD CARD 1