HomeMy WebLinkAbout825 Boltz Dr - Applications/Plumbing - 10/28/2002City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 5W • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
La t First
Middle
Phone
P7,444ja A�.
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77-x/50
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Street Address Please Specify: LN. DR. CR. WY PL. ST CT RD. AVE.
City
e611tk(-1
State Zip Code
Co —
Company Name License Number
Supervisor & Cert. #
0
L
Mailing Address City
State
Zip Code
O
Phone
Please Specify: LN. DR. CR. WY. PL. ST CT. RD. AVE.
Zip Code
k
JOB SITE ADDRESS
Subdivision/PUD
C
CM
G
Filing Number Lo Block
Lot Area
Building Square Footage Number of Stories
Building Height
o
L
Number of Bedrooms/Bathrooms Finished Basement Square Footage
w
3
Value Construction
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of (including labor, material, profit) $
X
Description of Work:�—
OG�L
Ac + 00
C
/` C
112k
.5
Subcontractors:
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Electrical ( (4&— Mechanical
Plumbing
Roofing Concrete
Framer
I hereby acknowledge that I h this application and state that the above information is correct and agree to comply with all
;requirements contained I d 5ift-ardinances. and state laws regulating building construction.
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Print Name � YLy�` Phone / ;70
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE