HomeMy WebLinkAbout6033 MEDLAR PL - PERMITS - 2/11/2021Owner:TRAY FAMILY LIVING TRUST
6033 MEDLAR PL
FORT COLLINS, CO 80528-7166
Phone: 970-581-9973
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 #:13 Block #:4
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:ELEVATED INDEPENDENT ENERGY
10579 Quivas St
Northglenn, CO 80234
License #:ME-1665
Phone: 970-460-4970
Supervisor cert #:
Subcontractor(s)Phone License Number
Electrical:ELEVATED INDEPENDENT ENERG 970-460-4970 ME-1665
Work Description:
Installation of EV charger. No upgrade in service.
SCHEDULE INSPECTIONS: ** via Text Message: 888-406-6394 ** By Phone: 970-221-6769
** Online Portal: fcgov.com/CitizenAccess ** Online Portal via Mobile Device: fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 201 206 301 103 302 300
TOTAL FEES PAID AS OF 02/11/21: $74.30 Payment method:Credit Card 1363
** Fee Detail Displayed on Next Page
As a condition for the issuance of a permit, I hereby declare that I am the owneror owner's agent, authorized to perform the proposed workonthe property describedherein.
I agree to comply with all the requirements contained herein, and City ordinances, and State lawsassociated with suchwork. I understand that suchpermit may be
revoked in the event that issuance was basedonincorrect information. This permit shall becomenull and void if the workauthorized by suchpermit is not commenced,
suspended, abandoned or not inspected within 180 daysfromthe date of such permit.
Carbon Monoxide Alarm required within 15 feet of each bedroom entrance.
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 - fax
Building Permit #:B2101134
Issued Full:02/11/2021
Permit Type:Residential Electrical
Site Address: 6033 MEDLAR PL
Job Valuation:$400.00 Category:Residential
Signature:Print Name:Date:
Form Revised Oct 2010
Transactions
Method Check Number Date Paid Amount Paid Comments
Credit Card CK # 1363 02/11/2021 $74.30
Receipt issued:02/11/2021 Total Paid to Date:
$74.30
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due
City Sales/Use Tax 251.122030 $7.70 $7.70 02/11/2021 $0.00
County Sales/Use Tax 100.217030 $1.60 $1.60 02/11/2021 $0.00
Permit Flat Fee - $65 1000.422010 $65.00 $65.00 02/11/2021 $0.00
TOTAL FEES:$74.30 $74.30 $0.00
TOTAL BALANCE DUE AS OF 02/11/2021:$0.00
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 - fax
Building Permit #:B2101134
Issued Full:02/11/2021
Permit Type:Residential Electrical
Site Address: 6033 MEDLAR PL
Job Valuation:$400.00 Category:Residential
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010
Building Permit Ov er the Counter Application
2.
1 . Job site addres s:
6 033 medlar place
2 . Prope rty owne r name :
Robert Tray
3 . Prope rty owne r a ddress:
Stre et Address: : 60 33 Me dl ar Pl
Ci ty: : Fort C ol lins
State: : CO
Zip : : 80528
4 . Prope rty owne r phone number:
(970) 58 1-99 73
5 . Project type:
Resid en tial
6 . What ty pe of res idential?
Single Family D etach ed
7 . Value of work (La bor a nd Mate r ia ls )($):
4 00
8 . Ty pe of permit:
Electrical
Pleas e note: e ach individual lot require s a se parate applic ation and perm it.
Pleas e note: e ach individual applianc e requir es a sepa rate application and permit.
1 0. Scope of work :
Other electri cal altera tions:: Instal la tion o f EV charger
1 1. Serv ice upgrade:
No
1 2. Contrac tor name:
Elevated in depen dent energ y
1 3. Contrac tor addr ess:
7 000 N Broad way #205, Denver, C O 80201
1 4. Contrac tor phone number:
9 70-4 60 -497 0
1 5. Contrac tor email:
o ffice@ei nrg.com
1 6. Lic ense number ME-
0 00373 1
1 7. Additional infor mation if a pplicable:
Installation of El ectric Veh icle ch arge r
3. Review
1 8. I hereby a cknowledge tha t I have read this a pplication and s tate that the abov e informa tion is comple te and
c orrect. I agr ee to comply with a ll requirements containe d herein and c ity or dinance s and state laws regulating
building construction. I know that a perm it is not valid until it has be en paid and issue d.
Signa tu re of: Spen ser Judson
Date Signed:
0 2/11 /2 021
1 9. Please include an e m ail addre ss to receive a c onfirma tion and a c opy of your a nswers.
o ffice@ei nrg.com
4. Thank You!
Thank you for submitting your a pplication for pr ocess ing.
To submit a nother over the counte r a pplica tion, click here.