HomeMy WebLinkAbout824 Benthaven St - Applications/Garage - 08/14/2002City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last
lirst
Middle Phone
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Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT. RD AVE.
City State Zip Code
62V
.APT
Company Name
License Number
Supervisor & Cert. #
0
Mailing Address
City
State Zip Code
G)
Phone
Please Specify: LN. DR.
t 8
CR. WY. PL. ST. CT. RD. AVE. Zip Code
N
Subdivision/PUD
d
a
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Filing Number
Lot Block
Lot Area
T4
Building Square Footage
Number of Stories
guilding Height
Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
y
Stock Plan Number
Options
y
Water Tap Size
Sewer Tap Size
Metered
w
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
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(including labor, material, profit) $
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Description of Work:
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Job Contact Name & Phone #: n p
Subcont actor Names:
Electrical _Mechanical ,( )6Il t5- Plumbing ,)DAB
Framer L /C Roofing g*6
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.
C
A
'a Signature
a Print Name �fGvt� ps 014 - --76Z7
'� Phone M — Z2- % —O/ 29
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater