HomeMy WebLinkAbout6126 TILDEN ST - PERMITS - 6/9/2005Community Planning & Environmental Services
Building & Inspections Division
046%mx.m. P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
City U29i9MIX phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS
BUILDING PERMIT
Building Valuation
B0502794 JACCOUNT
PERMITTYPE I PERMIT LEVEL
LU
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Addr
City/State
O
Zip 6126 TILDENPhone
No. FOFIT .
Front Rear
Setback
Z_
Right Side Setback Left
Side Setback
Z
Plat File No.
ZBA Case Number
Zoning District
J
Subdivision/PUD
Filing
�j
J
Lot Block Lot Area
Parcel No.
OCompany
Name Contractor
License No.
Address City/State
Phone
Supervisor Cert. No.
V
Electrical
License No.
License No.
OMechanical
F—
Roofing
License No.
Z
Framing
License No.
V
m
Plumbing
License No.
N
Concrete
License No.
CATEGORY TYP 4 ' J Budding PeriRi t w/o Subs
'ClWn.MbnType Occupancy Grou dial City Sales/Use Tax
LU
t
p No. of Stories Building Height County Sales Use Tax
0
Building Square Footage I Stock Plan/options
(See reverse side for Inspection Description)
FNE PE EC
HOMEOWNER TO EXTEND EXISTING CIRCUITS IN BASEMENT TO PROVIDE ADDITIONAL OUTLETS.
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 PaAte of such permit or from the date of the last inspection.
ku /q. oLeIVDFR 9 ,lupiP zoo s
Print name of owner/agent Signature Date
FEE
$15.0) 6/9/05
$0.9 6/9/05
$0.2 6/9/05