HomeMy WebLinkAbout925 QUEENS CT - PERMITS - 6/13/2005Community Planning &Environmental Services
Building & Inspections Division BUILDING PERMIT
PERMIT
FEES
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 B050` 1
ACCOUNT
FEE 4.
DATE PAID
SITE ADDRESS PERMIT DATE
JOB
PERMIT
925 QUEENS CT 'CC)
TYPE
Sui1U1in Permit a Subs
� /u
$15.0
6;13/C5
PERMIT LEVEL CATEGORY TYPE
Last Name, First, MiEdd Initial Electrical Alteration ISSU FUL Residential
City Sales/Use tax
$4. S
S/13/C5
Construction Type Occupancy Group
w
Address Cit /State w
Y p No. of Stories Building Height
County Sales/Use Tax
$1.In
6/1'/fz
u u
925 QUEENS CT FORT COLLINS,CO
O
Zip 80525-4625 221-5819 Phone No. l J Building Square Footage Stock Plan/Options
Front Setback
Rear Setback
!�
Z
Right Side Setback Left
Side Setback
•
Z
Plat File No. ZBA Case Number Zoning District
Subdivision/PLID Filing
(See reverse side for Inspection Description)
F RE L P
uj
Lot Block Lot Area Parcel No.
J
4 972It41505C
Name Contractor License No.
OCompany
Address
City/State
I—
Z
Phone Supervisor Cert. No.
V
Electrical License No.
(t F i FnTnTl` nn + r MF 825
1�e
Mechanical
License No.
C
Roofing
0
Framing
License No.
License No.
U
SO
Plumbing
License No.
N
Concrete
License No.
REPLACE BROKEN METER MAIN
8
I —
As
a condition for the issuance of a permit, I hereby declare that I am an owner or the owner's agent, authorized to perform the proposed work on the property
described
herein. I agree to comply with all City ordinances, and State laws associated with such work. I understand that such permit may be revoked in the
event
that issuance was based on incorrect or incomplete information. This permit shall become null and void if the work authorized by such permit is not
commenced,
suspended, abando d or inspected within 180 days from the date -of -such perm i r from the date of the last inspection.
name o owner/agent AignatuW1 Date 3
Print
TOTAL FEE$
7