HomeMy WebLinkAbout4112 MOUNT VERNON CT - PERMITS - 6/6/2005Community Planning &Environmental Services
FEES
Building & Inspections Division BUILDING PERMITPERMIT
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 B 0 5 0 2 6 S 1
ACCOUNT
FEE
SATE` PAID
JOB
SITE ADDRESS
PERMIT DATE
PERMIT
4112 MOUNT
TYPE
0/'�/
E 'Cf:; LiiV5
Building Permit w/o Subs
$38.5
6116/05
PERMIT LEVEL
ROOF Roofing - ReRoofin ISSU_FUL
CATEGORY TYPE
Residential
City Sales/Use`Tax
County Sales/l;se lax
$45.0
$12,0
6/6/05
6/6/05
ix
w
Last Name, First, Middle Initial
NEWLIN DOUGLASR
Construction Type Occupancy Group
Address City/State
4112 MOUNT VERNON CT FORT COLLINS, CO
Wp No. of Stories Building Height
O
Zip 80525-3335 Phone No.
V Building Square Footage Stock Plan/Options
Front Setback
Rear Setback
Z
Z
Right Side Setback
Left Side Setback
• • • •
N
Plat File No. ZBA Case Number Zoning District
Subdivision/PUD Filing
(See reverse side for Inspection Description)
QOIV,
J
wLot
Block Lot Area Parcel No.
0 8731306001
Name Contractor License No.
OCompany
Address City/State
1--
OPhone
Supervisor Cert. No.
V
Electrical License No.
W
Mechanical License No.
GRoofing
License No.
Framing License No.
ZO
V
Plumbing License No.
N
Concrete License No.
TEAR OFF TO DECKING AND REROOF WITH 30 SQUARES
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.
name of owner/agent Signaturet—/&-*%0` Date
Print
TOTAL FEES
$95.