HomeMy WebLinkAbout4616 WITHERS DR - PERMITS - 5/13/2016of
F6rt` �Coll
Site Address: 4616 WITHERS DR
Job Valuation: $3,378.34 Category: Residential
Owner: HURST LIVING TRUST
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1602552
Issued Full: 05/13/2016
Permit Type: Residential Mechanical
4616 WITHERS DR
FORT COLLINS, CO 80524 Phone: 970-219-7664
Zoning: Front setback: Rear setback: Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: LMN - LOW DENSITY MIXED -USE NEIGHBORHOOD DISTRICT
Legal: Subdivision/PUD: Filing #: Lot #: 35 Block #:
Code: Res sq ft: Com sq ft: Ind sq ft: Basement sq ft:
# of stories: Occ Group: Const Type:
Fire Sprklr: Stock plan #: Stock plan options:
Contractor: POUDRE VALLEY AIR . , License #: H-835 Supervisor cert #:
2416 DONELLA CT #A
FORT COLLINS, CO 80524.
Subcontractor:(s).
Mechanical: POUDRENALLEY AIR,
i I
y.
Work Description: Replace air conditioner
SCHEDULE INSPECTIONS: *** By Phone: 970-221-6769 *** By Web: http://www.fcgov.com/CitizenAccess
***By Mobile Device: http://www.fcgov.com/CitizenAccess/mobile
Inspections: GL FNM FNP FNE
TOTAL FEES PAID AS OF 05/13/16: $101.01 Payment method: Trust Account
`• Fee Detail Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare 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 incorrect 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 Monoxide Alarm required within 15 feet of each bedroom entrance.
Signature:
Print Name:
Date:
Form Revised Oct 2010
City of
F6rt Collins
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: 131602552
Issued Full: 06/13/2016
Permit Type: Residential Mechanical
Site Address: 4616 WITHERS DR
Job Valuation: $3,378.34 Category: Residential
Transactions
Method Check Number Date Paid Amount Paid Comments
Trust Account 05/13/2016 $101.01
Receipt issued: 05/13/2016 Total Paid to Date: $101.01
Fee Description Account Code Fee Amount Amount Paid
City Sales/Use Tax 251.122030 $65.03 $65.03
County Sales/Use Tax 100.217030 $10.98 $10.98
Permit Flat Fee w/o Subs $25 1000.422010 $25.00 $25.00
TOTAL FEES: $101.01 $101.01
Date Paid
Amount Due
05/13/2016
$0.00
05/13/2016
$0.00
05/13/2016
$0.00
$0.00
$0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.