HomeMy WebLinkAbout418 WOOD ST - PERMITS - 6/3/2021City of
k tColli~
Site Address: 418 WOOD ST
Job Valuation: $3,000.00 Category : Residential
Owner: Tab Hackney
418 Wood St
FORT COLLINS, CO 80525
Co mmu nity Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970 .221.6760 970.224.6134 -fax
Building Permit#: B210431 0
Issued Full: 06/03/2021
Permit Type: Residential Plumbing
Phone: 646-258-2115
Zoning: Front setback ______ Rear setback: _____ Right setback: ____ _ Left setback
Minor Amend#: ______ Plat Fi le#: _____ ZBA Case #:
Zoning district NCM -NEIGHBORHOOD CONSERVATION -MEDIUM DENSITY DISTRICT
Legal : Subdivis ion/PUD
Code: Res sq ft:
________________ Filing#: Lot#: Blo ck#:
# of stories:
Fire Sprklr
Com sq ft:
0cc Group:
Stock p lan #: ___ _
Contractor: M IKE'S PROPERTY SERVICE
133 Regina Drive
FORT COLLINS , CO 80525
Subcontractor(s)
Work Description: Replace 10 ft. of sewer line.
--------
Ind sq ft: Basement sq ft: --------Const Type: ---------------------Stock plan options : ------------------
License #: ROW-19001 16 Supervisor ce rt#
Phone: 970-420-8757
Phone License Number
SCHEDULE INSPECTIONS : ** via Text Message: 888-406-6394 ** By Phone : 9 70-221-6769
** Online Portal: fcgov.com/CitizenAccess ** Online Po rtal via Mobile Device: fcgov.com/CitizenAccess/mobile
Possible Inspections Required: 200 204 102 301 302 300
TOTAL FEES PAID AS OF 06/03/21: $134.75
** Fee Detail Displayed on Next Page
Payment method : T rust Account
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 understan d 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 pe•mit.
Carbon Monoxide Alarm required with in 15 feet of each bedroom entrance .
Signature: Prin t Name: Date: -------------------------------------
Form Revised Oct 2010
City of
,ktColli~
Site Address: 418 WOOD ST
Community Development & Neighborhood Services
281 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.6134 -fax
Building Permit#: 82104310
Issued Full: 06/03/2021
Permit Type: Residential Plumbing
Job Valuation: $3,000.00 Category: Residential
Transactions
Method Che~k NYWQ!i![ oat!i:! eaid
Trust Account 06/03/202 1
Receipt issued: 06/03/2021 Total Paid to Date:
Fee Descri12t ion Account Code
City Sales/Use Tax 251.122030
County Sa les/Use Tax 100 217030
Permit Flat Fee -$65 1000.422010
TOTAL FEES:
Amount eaid Comw!i:!n1l2
$134 .75
$134.75
Fee Amount Amount Paid Date Paid
$57.75 $57 .75 06/03/2021
$12.00 $12.00 06/03/2021
$65.00 $65.00 06/03/2021
$134.75 $134 .75
TOTAL BALANCE DUE AS OF 06/03/2021 :
Amount Due
$0.00
$0.00
$0 .00
$0.00
Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010
Cityof k_!Soll~ PLUMB I NG PERMIT APPLICATION
Community Development and Neighborhood Services
281 N College buildingservices@fcgov.com
Fort Collins, CO 80524 970-416-2740
Application # \3 •2, I D{~ \ ()
Date Received (p I!, lz I
ALL information is REQUIRED. Incomplete applications will not be accepted.
Job Site Address .. 'i a.Jc .. ,,,/Sf:-
Address !fl VL¼1
Property_ Owne<lnm .
Name ~~ & ~
Address J/ LJ)=}/:
. ../_. ···-·-----· -···-·-·--··················--··--··-··-··· -· ··-··----·----····
efsingle Family Detached Q Townhome (attached} Q Duplex Q ApartmenUCondo 0 Garage/Other
--·-' ··-' -. --------. ----·-·-----·--·· ·------·--·-· --------·--·-·-· ----··-··· -··-· ----·--··--. ··-···------. - -
II • Q Bank Q Bar Q Church Q Hotel/Motel Q Medical Office Q Office O Retail
--------------~----------·--··-··--··-·--·.
Value of Work
Labor and Materials$ ___ :2i_o_o_D ______ _
Scope of Work
0 Sewer line replacement / new
0 Water line replacement/ new
0 Jas line replacement / new
0 Other plumbing work
Additional Information
(if applicable)
t.h ... l Feet to be replaced / installed ---1,--,._D/.z__ ____ _
Feet to be replaced / installed ________ _
Feet to be replaced / installed ________ _
.J:~f J"L<( /2tt11i'
-------........ --
0 Restaurant
Plumbing C
Name -+-,r.-f...Pa:,::_"'7r--~'----"-l-~~f-----"_)(==--lYJ-=---.,lJ.:....:1/,=c_,=-~-=------------:;;,-::--:-;-~-.--
City/State/Zi14/hl/4"45 {),/rJ ,Rf)'iJ> Address 11 · ·f;
Phone Number q to i/:Jb r;f15'?
License Number _____________ _
Email -o,-,.q,J.-"<r;_,5,_a"'-.71~y--.=a.V=' -o~L-1:l~Mi-i~,_U;~JV[~-----
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,
. --·--·-·-.. signature ffe4 {Zd