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HomeMy WebLinkAbout1112 CENTENNIAL RD - PERMITS - 7/13/2021City of ktColli~ Site Address: 1112 CENTENNIAL RD Job Valuation: $4,800.00 Category: Residential Owner: NORTHERN COLORADO REAL ESTATE 1112 CENTENNIAL DR FORT COLLINS, CO 80525-9679 Zoning: Front setback: Rear setback Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: B2105501 Issued Full: 07/13/2021 Permit Type: Residential Plumbing Phone: 970-218-1691 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 Ind sq ft: Filing# Lot# Block#: # of stories: Fire Sprklr: 0cc Group: Const Type: ____________________ _ Stock plan #: ____ Stock plan options: Basement sq ft: _______ _ Contractor: MIKE'S PROPERTY SERVICE 133 Regina Drive License# ROW-1900116 Supervisor cert# FORT COLLINS, CO 80525 Subcontractor( s) Work Description: Replace 20 ft of sewer line. Phone: 970-420-8757 Phone License Number 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: 200 204 102 301 302 300 TOTAL FEES PAID AS OF 07/13/21: $176.60 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 owner's 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 ktColli~ Site Address: 1112 CENTENNIAL RD Community Development & Neighborhood Services 281 N. College Ave Fort Collins, CO 80522 970.221.6760 970.224.6134 -fax Building Permit#: 82105501 Issued Full: 07/13/2021 Permit Type: Residential Plumbing Job Valuation: $4,800.00 Category: Residential Transactions Method Check Number Date Paid Amount Paid Comments Trust Account 07/13/2021 $176.60 Receipt issued: 07/13/2021 Total Paid to Date: Fee Description City Sales/Use Tax County Sales/Use Tax Permit Flat Fee -$65 Account Code 251.122030 100.217030 1000.422010 TOTAL FEES: $176.60 Fee Amount Amount Paid $92.40 $92.40 $19.20 $19.20 $65.00 $65.00 $176.60 $176.60 Date Paid 07/13/2021 07/13/2021 07/13/2021 TOT AL BALANCE DUE AS OF 07/13/2021: Amount Due $0.00 $0.00 $0.00 $0.00 Fee Amounts are valid for date of this document only. Fees subject to change without notice. Form Revised Oct 2010 City of ~ort Collins. ·'~ Community Development and Neighborhood Services 281 N College buildingservices@fcgov.com Fort Collins, CO 80524 970-416-27 40 PLUMBING PERMIT APPLICATION Date Received ALL information is REQUIRED. Incomplete applications will not be accepted. 0 Townhome (attached) 0 Duplex 0 ApartmenUCondo O Garage/Other 0 Bar O Church O Hotel/Motel O Medical Office O Office Value of Work 4 ( ,I i \ Labor and Materials$ ____ ~_W _______ _ Scope of Work 42?sewer line replacement/ new 0 Water line replacement / new 0 Gas line replacement / new 0 Other plumbing work Feet to be replaced / installed ________ _ Feet to be replaced / installed ________ _ Additional Information (if applicable) Plumbing Contractor or Excav ·on Company C , Name k e, J (0. e, _;;,.e;'{Vf c:..G Address (33 {2:¢j j".':-9< D ( Phone Number ?/1() (,/:}{) JJ'l 51 License Number _____________ _ Email I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a permit is not valid until it has been paid and issued. ____,I_D,te ~~