HomeMy WebLinkAbout5320 Corbett Dr - Applications - 08/13/2002City of Fort Collins
BUILDING PERMITS & INSPECTIONS DmsION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last First
c Street Address Please Specify: LN. DR. CR. WY.
Company Name
L
Mailing Addres City
L\�
31
C
Phone
RD.
sor &
C1 RD.
1:rSu
vision/PUD
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Lot Block
Lot Area
ao
a
Building Square Footage
NumbeStories
ca
Number of Dwelling Units
Number of Bedtooms/Bathrooms Unfir
C,
Stock Plan Number/Options
Radon
Energy Sc
Y N
ca
Water Tap Size
Serer Tap Size
=
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric
as ❑ Electric
150 amp or less ❑ 200 amp ❑ other
Yes ❑ No
1 1 1 (including labor, material, profit) $
Ic,
Description
of Work:
Phone
`0-6
Requested:
CC., \ N—
Job Contact Name & Phone #: r
Subcontractor Ngmes: t \
Electrical �,� Mechanical Plumbing 1}�,Y•��n� ,\a
Framer — �S Roofing _ � . [��� Concrete VQ� r
II 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.
Signature
Print Name Phone Vw1 --cn
Distri n: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE