HomeMy WebLinkAbout528 E PITKIN ST - PERMITS - 3/30/2021City of
k tColli~
Site Address: 528 E PITKIN ST
Job Valuation: $8,000.00 Category: Residential
Owner: BARTON JENN IFER D/BRYANNE B
528 E PITKIN s-
FORT COLLINS, CO 80524-3817
Community Development & Neighborhood Services
281 N . College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#: B2102315
Issued Full : 03/30/2021
P e rmit Type: Residential P lu mbing
Phone: 719-661 -9915
Zon ing: Front setback ______ Rear setback: _____ Right se t back: ____ _ Left setback:
Mi nor Amend#: ______ Plat Fi le#: _____ ZBA Case #:
Zoning district NCM -NEIGHBORHOOD CONSERVATION -MED I UM DENSITY DISTRICT
Legal : Subd ivision/PUD:
Code: Res sq ft:
# of stories:
________________ Filing#
Com sq ft:
0cc Group:
Ind sq ft:
Const Type:
Lot#:
Basement sq ft:
B lock#:
--------
Fire Sprklr: ---------------------Stock plan #: Stock plan options: ----------------------Contractor: MIKE'S PROPERTY SERVICE
133 Regina Drive
License #: ROW-1900116 Supervisor ce rt#
FORT COLLINS, CO 80525
Subcontractor(s)
Work Description: Repair 20 ft of sewer line and add clean outs.
Phone: 970-420-8757
Phone License Number
SCHEDULE INSPECTIONS : ** v ia Text Message: 888-406 -6394 ** By Phone : 970 -221-6769
** Online Portal : fcgov .com /CitizenAccess ** Online Portal via Mobil e Device : fcgov .com /Ci ti zenAccess/mobi le
!Possible Inspections Required: 200 204 102 301 302 300
TOTAL FEES PAID AS OF 03/30/21: $251.00 Payment method: Credit Card 4336
** 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. Th is 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 : 528 E PITKIN ST
Community Development & Neighborhood Services
281 N . College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#: B2102315
Issued Full: 03/30/2021
P ermit Type: Residential Plumbing
Job Valu ation: $8,000 .00 Category: Residentia l
Tra n sactions
Method Check Number Date Paid
Credit Card CK# 4336 03/30/2021
Receipt issued: 03/30/2021 Total Paid to Date:
F ee Descri~tion Account Code
City Sales/Use Tax 251 .1 22030
County Sales/Use Tax 100.217030
Permit Flat Fee -$65 1000.422010
TOTAL FEES:
Amount Paid Comments
$251.00
$25 1.00
Fee Amount Amount Paid Date Pa id
$154.00 $154.00 03/30/2021
$32.00 $32 .00 03/30/2021
$65.00 $65.00 03/30/2021
$251.00 $251.00
TOTAL BALANCE DUE AS OF 03/30/2021:
Amount Due
$0.00
$0.00
$0.00
$0.00
Fee Amounts are valid_ for d ate of this document only. Fees subject to change wit hout notice.
Form Revised Oct 2010
Cltyof
k~ol~s
Community Development and Neighborhood Services
281 N College buildingservices@fcgov.com
Fort Collins, CO 80524 970-416-27 40 Date Received
ALL information is REQUIRED. Incomplete applications will not be accepted.
JobSiteAddress ... tO :---f/ i,,L ri'•
Address 2 ~'1-~ r /;(J, 1
Property Owner Info ·
City/State/Zip W~@ !/411.,5 (ffe
90?'~/o
Phone Number --'<-L.7;+-f -=--"a0"--'--:;:I ,__,__f¥;.c....=.-1/ 5: __ ~ Name .. , /"_
Address -5
\{~'-/' ., •'" ,, .\ < " :: i. ,.·,
Q RESIDENTIAL.'.
' ,.o/ 1/. ~ t ;. ~
Osank Osar Qchurch
City/State/Zip &'f/6/ ?ft.J (a,/ U -
g05.;; (-
0 Duplex O ApartmenUCondo O Garage/Other
0 Hotel/Motel O Medical Office O Office ORetail 0 Restaurant
Value of Work !}/
Labor and Materials$ __ J~_ tf()_[} _______ _
S~~ofWork r;; Sewe, line ,e~acement I new
0 Water line replacement / new
0 Gas line replacement / new
0 Other plumbing work
Additional Information
(if applicable)
Feet to be replaced / installed ---'d=-_~_,,_..._ ___ _
Feet to be replaced/ installed ________ _
Feet to be replaced / installed ________ _
_J
Address __ -t---'-----L-:::--'--,:;;,1--''-'--~--"'..C..,..-=-------------,---
Phone Number L) l(jo 51 Email ---'LW"'--t..:..>::.L..J-=:....=-'---=c...L.:!....:......>'--'.._;:__:........,""'------>
License Number tll.JJ()j "-f t!ztJ tf //?
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.
Print Name /rt k{ _£v:A ~I Date 3/)fJ(