HomeMy WebLinkAbout400 Derry Dr - Applications/Basement Finish - 10/03/2002BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
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Middle
Phone
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Street Address Please Specify: LN. R
CR. WY. PL. ST CT. RD. AVE.
City State
Zip Code
400 Drcc
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Company Name
License Number
Supervisor & Cert. #
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Mailing Address
City
State
Zip Code
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Phone
Please Specify:
LN. DR. CR. WY PL. ST CT. RD. AVE.
Zip Code
JOB SITE ADDRESS
D O
,Subdivision/PUD
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Filing Number L
Block
Lot Area
Building Square Footage
Number of Stories
Building Height
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Number of Bedrooms/Bathrooms
Finished Basement Square Footage
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Value of Construction (including labor, material, profit) $
Description of Work: I,,
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Subcontractors:
Electrical
Roofing
Mechanical
Concrete
Plumbing
Framer _
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.
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Signature
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Print Name Kay-rv-, D" Fr -\Y\ Phone �4Q l — t7 ZeA
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE