HomeMy WebLinkAbout4700 LADY MOON DR - PERMITS - 3/14/2017F&tc'ollins
Site Address: 4700 LADY MOON DR
Job Valuation: $85,000.00 Category:
Owner: BANNER HEALTH
1441 N 12TH ST
PHOENIX, AZ 85006
Zoning: Front setback:
Rear setback:
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1700265
Issued Full: 03/14/2017
Permit Type: Com, Ind or Mixed Use Alteration
Phone: 970-631-6075
Right setback: Left setback:
Minor Amend #: Plat File #: ZBA Case #:
Zoning district: HC -HARMONY CORRIDOR DISTRICT
Legal: Subdivision/PUD:
Filing #: Lot #: Block #:
Code: Res sq ft: 0 Com sq ft: Ind sq ft: Basement sq ft:
# of stories: Occ Group: 1-2 Const Type: I-B
Fire Sprklr: Yes Stock plan #: Stock plan options:
Contractor: AP MOUNTAIN STATES, LLC DBA ADOLFSON 8,
PETERSON INC'�
797 VENTURA ST,
AURORA, CO 8001Y�,
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Electrical:
LGREI
Mechanical:
CIS E
Plumbing:
USE
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FKENI
Job Contact:
r'
Work Description: Tenant finish remodel of 30 sq;ft
changing room and. mammography=suite._Minor-elec
Authorization on file.
License #: B-157 Supervisor cert#: 2078-B
Phone: 303-363-7101
r-
r] License Number
M E-767
�H�1062—�
MP-100_
it -"Banner Health" to include changing conference and office into
new sink (connecting to existing sewer line). Building Owner
II SCHEDULE INSPECTIONS: """ By Phone: 970-221-6769 *** By Web: http://www.fcgov.com/CitizenAccess II
***By Mobile Device: http://www.fcaov.com/CitizenAccess/mobile
Inspections: FP UGP HC IN FD RM HD SBF FNB EG SWR WTR FIR RE RP GL FINE FNP FNM UGE AW
TOTAL FEES PAID AS OF 03/14/17: $1,449.01 Payment method: Check 685281
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 pemmt.
Signature: PrintName: J�„ �, .� ( ,� Date: / Y %/ 7
Forth Revised Oct 2010
/OvF�o�rfCollins
Site Address: 4700 LADY MOON DR
Job Valuation: $85,000.00 Category:
Transactions
Method Check Number pate Paid
Check CK # 685281 03/10/2017
Credit Card CK# 0368 01/20/2017
Receipt issued: 03/14/2017 Total Paid to Date:
Fee Description Account Code
Building Permit Fee w/Subs 1000,422010
Plan Check Fee 1000.444010
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.676o 970.224.6134 -fax
Building Permit #: B1700265
Issued Full: 03/14/2017
Permit Type: Corn, Ind or Mixed Use Alteration
Amount Paid Comments
$978.08 Adolfson & Peterson Construction paid by CK# 685281
$470.93 BRYAN KAGELMAN PAID WITH CC
$1,449.01
Fee Amount Amount Paid Date Paid Amount Due
$978.08 $978.08 03/10/2017 $0.00
$470.93 $470.93 01/20/2017 $0.00
TOTAL FEES: $1,449.01 $1,449.01 $0.00
TOTAL BALANCE DUE AS OF 03/14/2017: 0.00
0 I
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Fee Amounts are valid for date of this document only. Fees subject to change without notice.