HomeMy WebLinkAbout612 BALSAM LN - PERMITS - 12/18/2018ins
)llegeAve Fort Collins, CO 8o522
970.221.676o 970.224.6134 -fax
Address: 612 BALSAM LN
Valuation: $2,800.00 Category: Residential
CRUZ JUSTIN R/FELICIANO M
1167 N LOGAN ST APT 12
DENVER, CO 80203-2492
Building Permit#: B1810856
Issued Full: 12/18/2018
Permit Type: Residential Plumbing
Phone: 970-689-6789
ing: Front setback: Rear setback: Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: RL - LOW DENSITY RESIDENTIAL DISTRICT
: Subdivision/PUD:
Res sq ft: Com sq ft:
# of stories: Occ Group:
Fire Sprklr: Stock plan #:
ontractor:
Filing #: Lot #: Block #:
Ind sq ft: Basement sq ft:
Const Type:
Stock plan options:
License #:
Phone:
,,---Phone n
r i
Work Description: Replace 60"of,sewer service and 5' deep'inst dual -sweep clea
Supervisor cert#:
License Number
1
k to be completed by Tru`Elite Pipe MD.
II SCHEDULE INSPECTIONS: ** Text Message: 888-406-6394 ** Website: http://www.fcgov.com/CitizenAccess III
** Phone: 970-221-6769 **Mobile Website: http://www.fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 200 204 102 301 302 300
TOTAL FEES PAID AS OF 12/26/18: $138.10 Payment method: Credit Card 3348
* Fee Detail Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare that I am the owneror 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 fromthe date of such permit
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Print Name.owk J, SGr�'�`�z' Date: lZ%L7/'6'
ins970.221.676o 970.224.6134 -fax
Building Permit#: B1810856
Issued Full: 12/18/2018
Permit Type: Residential Plumbing
Address: 612 BALSAM LN
Valuation: $2,800.00 Category: Residential
thod Check Number Date Paid Amount Paid Comments
:dit Card CK# 3348 12/18/2018 $138.10
ceipt issued: 12/26/2018 Total Paid to Date: $138.10
e Description Account Code Fee Amount Amount Paid Date Paid Amount Due
Iding Permit Fee Without 1000.422010 $76.50 $76.50 12/18/2018 $0.00
)s
f Sales/Use Tax 251.122030 $53.90 $53.90 12/18/2018 $0.00
inty Sales/Use Tax 100.217030 $7.70 $7.70 12/18/2018 $0.00
TOTAL FEES: $138.10 $138.10 $0.00
. ` TOTAL BALANCE DUE AS OF 12/26/2018: 0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.