HomeMy WebLinkAbout1020 ALEXA CT - PERMITS - 8/26/2021 I
Community Development&Neighborhood Services
282 N. College Ave Fort Collins, CO 80522
970.221.6760 970.224.61S4 -fax
F6rt Collins
Building Permit#: B2106907
~� Issued Full: 08/26/2021
Permit Type: Residential Gas Log
Site Address: 1020 ALEXA CT
Job-Valuation: $6,000.00 Category: Residential
Owner: RICE LARRY A/DIANE C
1020 ALEXA CT
FORT COLLINS, CO 80526 Phone: 970-214-7708
Zoning: Front setback: Rear setback: Right setback: Left setback:
Minor Amend#: Plat File#: ZBA Case #:
Zoning district: RL-LOW DENSITY RESIDENTIAL DISTRICT
Legal: Subdivision/PUD: Filing#: Lot#: Block#:
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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: WESTERN FIREPLACE SUPPLY License#: FP-1815 Supervisor cert#:
1408 RIVERSIDE AVE
FORT COLLINS, CO 80524 Phone: 970-498-9679
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Subcontractor(s) Phone License Number
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Work Description: Replace gas fireplace, no new gas line to be installed.
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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: 406 204
TOTAL FEES PAID AS OF 08/26/21: $204.50 Payment method: Credit Card 3030
*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 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
Community Development&Neighborhood Services
l�J 281 N. College Ave Fort Collins CO 80522
6rt Collins 970.221.676o 970.224.6134 -fax
Building Permit#: B2106907
Issued Full: 08/26/2021
Permit Type: Residential Gas Log
Site Address: 1020 ALEXA CT
Job Valuation: $6,000.00 Category: Residential
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Transactions
Method Check Number Date Paid Amount Paid Comments
Credit Card CK#3030 08/26/2021 $204.50
Receipt issued: 08/26/2021 Total Paid to Date: $204.50
Fee Description Account Code Fee Amount Amount Paid Date Paid Amount Due i
City Sales/Use Tax 251.122030 $115.50 $115.50 08/26/2021 $0.00
County Sales/Use Tax 100.217030 $24.00 $24.00 08/26/2021 $0.00
Permit Flat Fee -$65 1000.422010 $65.00 $65.00 08/26/2021 $0.00
TOTAL FEES: $204.50 $204.50 $0.00
TOTAL BALANCE DUE AS OF 08/26/2021: $0.00
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Fee Amounts are valid for date of this document only. Fees subject to change without notice.
Form Revised Oct 2010
City of
W APPLIANCES
PERMIT APPLICATION
Community Development and Neighborhood Services n
Application# o-7
281 N College buildingservices@fcgov.com
Fort Collins,CO 80524 970-416-2740 Date Received
ALL information is REQUIREO.,Incomplete applications will not be accepted.
Job Site Address //--
Address IC-11 /f x C1 C 7L City/State/Zip
Property Owner Information
Name cp,e V— 1. G►�s'�' �►^C Z° Phone Number &?7C — -1/ !�/.
Address lG1� t'�X�' 7� City/State/Zip
"� ', k,dad ,�' ".-,e•�,.��k __ __-- - - �
. - ® Single Family Detached O Townhome(attached) O Duplex O Apartment/Condo 0 Garage/Other
- 0 Bank Bar Q Church Q Hotel/Motel Medical Office Office Retail 0 Restaurant
Value of Work
Labor and Materials$ (ice C
Scope of Work
Q Wood/Pellet stove(required to be EPA approved) Model Name j
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Manufacturer
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Gas Fireplace Length of extensions of gas line(if necessary)
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Please list plumber if not completing
Q Fire Pit
fAdditional Information y ��� e�,9 /Q �t
(if applicable) 0 'r/ (. Ie4
Contractor
Name ` �i t
Name ifv �' � n P lMG V's �' � �►I/�C� r/ e J •��//'1
Address /Z �- �, y� y City/State/Zip V vg 5
Phone Number 24? (D Email ri/ ig &-r, CG r o'- 5*"-(-G�
License Number Certificate Number
Subcontractor License(if applicable) Subcontractor Name(if applicable)
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 • -• herein and city ordinances and state laws regulating building construction. I knoW that a permit is not
valid until it has been paid • issued.
Print Name ignature Date