HomeMy WebLinkAbout421 LILAC LN - PERMITS - 7/6/2005Community Planning & Environmental Services
Building & Inspections Division
P.O. Box 580 281 N. College Ave.
Fort Collins, CO 80522-0580
City of Fort Collins phone (970) 221-6760 Fax (970) 224-6134
JOB SITE ADDRESS 421 LILAC LN
PERMIT TYPE PER
ELEC Electrical Alteration
Last Name, First, Middle Initial
oe LEBSACK, VERNON
w Address
30 Zip 421 LI
80521
FORT COLLINS, CO
Phone No.
484-0246
Rear Setback
BUILDING PERMIT
Building Valuation
B0503313 ACCOUNT
PERMIT DATE
07/05/2005 Building Permit w/o Subs
.EVEL CATEGORY TYPE
ISSU_FUL Residential City Sales/Use Tax
Construction Type Occupancy Group
County Sales/Use Tax
Wp No. of Stories Building Height
O
Building Square Footage Stock Plan/Options
0
Z_
Right Side Setback Left Side Setback
Z
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Plat File No. ZBA Case Number Zoning District
J
Subdivision/PUD
Filing
Q
LU
Lot
Block
Lot Area
Parcel No,
J
9 712 34 2013
OCompany
Name
Contractor License No.
Address
City/State
i—
Z
Phone Supervisor Cert. No.
ce
Mechanical
License No.
O
Roofing
License No.
Framing
License No.
V
m
V)
Plumbing
License No.
N
PANEL CHANGE OUT
(See reverse side for Inspection Description)
FNE P,E EC
FEE
DATE PAID
$15.00
7
IJ6/V5
$7.50
7/6/05
$2.00
7/6/05
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.
� 46 OS
Print name of owner/agent Ign Dater— TOTAL FEES $24.