HomeMy WebLinkAbout6417 ORBIT WAY - PERMITS - 6/8/2021City of
,ktColli~
Site Address: 6417 ORBIT WAY
Job Valuation: $1,500 .00 Category: Residential
Owner: LEWIS ZACHARY C/ELIZABETH A
6417 ORBIT WAY
FORT COLLINS, CO 80525-4018
Zon ing : Front setback: Rear setback:
Community Development & Neighborhood Services
281 N . College Ave Fort Collins, CO 80522
970.221.6760 970.224 .6134 -fax
Bui lding Perm it#: B2104379
Issued Full: 06/08/2021
Permit Type : Residential Electrica l
Phone: 970-581 -5324
Right setback: ____ _ Left setback:
Minor Amend#: ______ Plat File#: _____ ZBA Case #:
Zoning district: RL -LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PUD: ________________ Filing#: Lot#: Block#: --------
Code : Res sq ft ____ Com sq ft: Ind sq ft ______ Basement sq ft: _______ _
# of stories : ____ 0cc Group: Const Type: ____________________ _
Fire Sprklr: ____ Stock plan #: ____ Stock plan options: _________________ _
Contractor: LAMB ELECTRIC, LLC License#: ME-1 340 Supervisor cert#:
2220 Franklin Road
Fort Col lins, CO 80524
Subcontractor(s)
Electrical LAMB ELECTRIC, LLC
Work Description: Change out panel. No upgrade in service.
Phone: 970-493-8628
Phone
970-493-8628
License Number
ME-1340
SCHEDULE I NSPECTIONS : ** via Text Message: 888-406-6394 ** By Phone: 970-221-6769
** Online Porta l : fcgov.com/CitizenAccess ** Online Portal via Mobile Device: fcgov.com/CitizenAccess/mobi le
!Possible Inspections Required: 201 206 301 103 302 300
TOTAL FEES PAID AS OF 06/08/21: $99.88
•• Fee Detail Displayed on Next Page
Payment method: Check 2430
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
k tColli~
Site Address: 6417 ORBIT WAY
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221 .6760 970.224.6134 -fax
Building Permit#: B2104379
Issued Full : 06/08/2021
Permit Type: Residential Electrical
Job Valuation: $1,500.00 Category: Residential
Transactions
Method
Check
Check Number
CK# 2430
Date Paid
06/08/202 1
Amount Paid
$99.88
Comments
Receipt issued: 06/0 8/2021 Total Paid to Date: $99.88
Fee Description
City Sales/Use Tax
County Sal es/Use Tax
Permit Flat Fee -$65
Account Code
251.122030
100.217030
1000.422010
TOTAL FEES:
Fee Amount Amount Paid
$28.88 $28.88
$6 .00 $6.00
$65.00 $65.00
$99.88 $99.88
Date Paid
06/08/2021
06/08/2021
06/08/2021
TOT AL BALANCE DUE AS OF 06/08/2021:
Amount Due
$0.00
$0.00
$0.00
$0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010
City of
~ort Collins
? ~
Community Development and Neighborhood Services
281 N College 970-416-2740
Fort Collins, CO 80524 buildingservices@fcgov.com
Application# i L u.i-l37 9
Date Received _---1.Q..:: 15": '~ \
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address
Address __ ~C,,~Y~I 1_0~r_b_r\-~W_Cl,_J-+---------------City/State/Zip Ee, Co <lo 5 z_ 5
Property Owner Information
Name f: L z a bx::::tb I e,.., " S Phone Number q 7D 5<:J I 5 3 2-'../
Address ___ fo~Y~ll_O~r-b=;~+_w_ec=j,---------------City/State/Zip FC, co ~osz.. <;
I
Single Family Detached Q Townhome (attached) Q Duplex Q Apartment/Condo 0 Garage/Other i i
.......... ·················--j
Q Bar Q Church Q Hotel/Motel Q Medical Office Q Office QRetail Q Restaurant
Value of Work
Labor and Materials$ _ _,_/5..c._o_o_. _o_o _______ _
Scope of Work ~----------............. .
Panel change out 0 Meter change out 0 Upgrade existing wiring
0 Panel Upgrade (May require additional review time. A commercial panel upgrade of 225A or 3 phase requires a 1 line diagram.)
0 other electrical alterations ----------------------------------
Service Upgrade O Yes ~o
Existing Amps __ ,_o_O __________ _
!-----··----·--· ······-
Additional Information
(if applicable)
Electrical Contractor Information
OD
Name l cLa::ib f (e ..__+,..,·c:._ U-.C
Address Z,2 2..0 .f=, 0-n le I, 11 R c;{
Phone Number q 7 0 581 lf D S 7
License Number ME-__ (_3___,_lf_O ________ _
Email
City/State/Zip FC, Co '€052-'-I-
C? o+(o,,mh 25 eya/,,ao -~)[\-
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 s;g,a,urn -------------