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HomeMy WebLinkAbout2820 Longboat Way - Applications/Single Family New - 05/30/2002BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 5W • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 2.2"134 City of Fort Collins BUILDING PERMIT APPLICATION Last First Middle Phone i4-3 HomE- C c Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. City State Zip Code f a E L✓� 1 E- ?mo o a E-" c-) E r-L Co 2 oZ 3 Company Name License Number Supervisor & Cert. # i Mailing Address City State Zip Code V c � Phone 3 ®3 ZZp loO loC� 1: Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. Zip Code III' A Subdivision/PUD CM co Filing Number + Lot [ 9 Block Lot Area I o B I y 0 Building Square Footage Number of Stories Building Height 1 q -1 c. Z 3© vr7 A LNumber of Dwelling Units Number of Bedrooms/Bathrooms Unfinishe 'nished Basement Sq. R. 3 -2— 9�t1 C., Stock Plan Number/Options Radon Energy Score/E-Star/Air Sealing/Blower Door 1 3 -1 to �t e,$; r I Y N �o e ,• �� 0CD O V L y Water Tap Size 3�y sewer Tap Size Metered ;. T e of Heat: Electric Main Breaker Size (Residential Only) TT—eXrary Electric Pedestal Requested: Gas ❑ Electric SU50 amp or less ❑ 200 amp ❑ other Yes ❑ No 1 1 1 (including labor, material, profit) $ 1 S 1 9 Z-ZLS Description of Work: fv #x Z 3 S - i Cf -1 (o C--. A-f-L-A (--, E . I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirements contained herein and city ordinances and state laws regulating building construction. -✓tJ a Signature CL Print Name C-P-c-) t'Lc ►'Yt o E_ L- C--Efl- Phone 3(='3 2-2-0 L-0 cd cf Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE