HomeMy WebLinkAbout1245 Truxtun Dr - Applications/Single Family New - 05/17/2002i C9 �
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last First
Middle Phone
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Street Address Please Specify. LN. DR. CR. WY. PL. ST. CT. RD. AVE.
City State Zip Code
Company ame License Number
Supervisor & Cert. #
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Mailing Address City
t Zip Code
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Phone
Please Specify: LN.. DR. CR. CR.
WY. PL. ST. CT. RD. AVE. Zip Code
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Subdivision/
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Filing Number Lot y Block
Lot A ea
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Building Square Footage Number of Stories
�, Building Height
20
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Number of Dwelling Units Number of d.rr�oorrBathrooms /Finished Basement Sq. Ft.
Stock Plan Number—c3PT'Dr-)5
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Waterl 1e Sewer Tap Size
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Metered
-5
Ty a of Heat:
EleEpic Main Breaker Size (Residential Only)
Electric Ped tal Requested:
Gas ❑ Electric
150 amp or less ❑ 200 amp ❑ other
TTe-Wpary
❑ No
1 1 9 1 (including labor, material, profit) $
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Description of work:
Job Contact Name }iPhone #:
Tn�r1r, bI,% 1 1
Subcontractor Names: '
Electrical 60Y) Mechanical J9//— Pj—z)daA Plumbing Pro P,,,mb
Framer,k tukji 0A6Wijh-u Roofing I5,p �, 11� �• r-YiX k.5?1k1
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.
SignatureWA"MYMJ MAH<
Print Name 141v1 `
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Phone
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Distribution:
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