HomeMy WebLinkAbout612 BALSAM LN - PERMITS - 4/20/2012City of
/,.F a rt Collins
Site Address: 612 BALSAM LN
Job Valuation: $1,200.00 Category: Residential
Owner: CREED JAMES E/MARY J TRUST
8013 S BARRY RD
COLUMBIA, MO 65201-9235
Zoning: Front setback: Rear setback:
Community Development 8r Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1202189
Issued Full: 04/20/2012
Permit Type: Residential Water Heater
Phone: 573-256-4858
Right setback: Left setback:
Minor Amend #: Plat File* ZBA Case #:
Zoning district: RL - LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PUD:
Code: Res sq ft: Com sq ft:
# of stories: Occ.Group:
Fire Sprklr: Stock plan #:
Contractor: ROBERTS HEATING & AIR
i
Filing #: Lot M Block #:
Ind sq ft: _
Const Type: _
Stock plan options:
Basement sq ft:
, License #: H-1602 Supervisor cert #:
200 LINCOLN
NUNN, CO 80648
Subcontractor I- \ ? 'i/
Mechanical: ROBERTS HEATING AIR
0 '' /'W✓ \
V
Work Description: REPLACE WATER HEATER. Instal
Safety Test prior to final approval l ,/
Phone: 970-897-2337
License Number
[] H-1602
appliances with a draft hood
SCHEDULE INSPECTIONS: *** By Phone: 970.221-6769 *** By Web: http://amos.fcgov.com/CitizenAccess
***By Mobile Device: http://amos.fcgov.com/CitizenAccess/amca/
Ins ections: FNP FNE FNM
TOTAL FEES PAID AS OF 04/20/12: $52.90 Payment method: Credit Card
*' Fee Deta// Displayed on Next Page
As a condition for the issuance of a permit, I hereby dedare that I am the owner or owners agent, authorized to perform the proposed work on the property described herein.
I agree to comply with all the requirements contained herein, and 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 intoned information. This permit shall become null and void if the work authorized by such permit is not commenced,
suspended, abandoned or not inspected within 180 days from the date of such permit.
Carbon Mono ide Alarm required within 15 feet of each bedroom entrance.
Signature: Print Name: IG M 06S r_f__ Date: " I z G
Form Revised Oct 2010
�.F�ort Collins
Site Address: 612 BALSAM LN
Job Valuation: $1,200.00 Category: Residential
Transactions
Method Check Number Date Paid
Credit Card 04/20/2012
Receipt Issued: 04/20/2012 Total Paid to Date:
Fee Description Account Code
City Sales/Use Tax 251.122030
County Sales/Use Tax 100.217030
Permit Flat Fee w/o Subs $25 1000.422010
Amount Paid
$52.90
$52.90
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -.fax
Building Permit #: B1202189
Issued Full: 04/20/2012
Permit Type: Residential Water Heater
Comments
PAID BY MIKE MISSIMER CREDIT CARD.
Fee Amount
Amount Paid
$23.10
$23.10
$4.80
$4.80
$25.00
$25.00
Date Paid
Amount Due
04/20/2012
$0.00
04/20/2012
$0.00
04/20/2012
$0.00
TOTAL FEES: $52.90 $52.90 $0.00
TOTAL BALANCE DUE AS OF 04/20/2012: 0.00
O �
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Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010