HomeMy WebLinkAbout4144 S TIMBERLINE RD - PERMITS - 9/12/2005Community Planning & Environmental Services
Building BUILDING PERMIT
PERMIT FEES
& Inspections Division
P.O. Box 580 281 N. College Ave.
Building Valuation
Fort Collins, CO 80522-0580
$600.00
City of Fort Collins Phone (970) 221-6760 Fax (970) 224-6134 F B0505204
ACCOUNT
FEE
DATE PAID
JOB
SITE ADDRESS 4114 S TWBERLINE RD
PERMIT DATE
- � 1 ' 6'� j
aA
PERMIT
TYPE
ELEC Electrical Alteration
PERMIT LEVEL
ISSUI_FUL
CATEGORY TYPE p,
Las,
Construction Type
Occupancy Group
LLJ
Z
Add'"! 8 W ASH ST UNIT A
c""sateWINDSOR. CO
1
Lu
0 No. of Stories
Building Height
0
V
Zip 805r-,C)
Phone No. 674-1109
-Building Square Footagt, Stock Plan/Options
Front Setback Rear Setback
Q)
Right Side Setback Left Side Setback
Z
Z
•
2
Plat File No. ZBA Case Number Zoning District C
(See reverse side for Inspection Description)
Subdivision/PLID Filing
uml
Lot Block Lot Area 0 Parcel No. j i f, n
F
Company Name Contractor License No.
0 Cd
Address City/State
O
Phone Supervisor Cert. No.
I
U
Electlfqal�r. License No.
L
Mechanical
License No.
0
Roofing
License No.
Z
Framing
License No.
8
Plumbing
License No.
Concrete
License No.
CONNECT IVIONUMENT SIGN ATCORNER OFTWBERLINE AND CARIBOU. INSTALL AS E'ER 2005 NEC
As
a condition for 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. 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 his permit shall become null and void if the work authorized by such permit is not
commenced,
suspended, abandoned or inspected within 180 days f9i5it the date of suc4ermit or from the date of the last inspection.
k'-?//
irg-natu -re Date
TOTAL FEES
Print
name of owner/agent