HomeMy WebLinkAbout6432 Carmichael St - Applications - 10/14/2002BUILDING PERMITS & INSPECTIONS DMSION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
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Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. City
State
Zip Code
Name
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License Nu r
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Su rvisor
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Specify: • LN. R. CR. WYtA. ST
D. AVE.
Zip Code
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SubdivisiCM V&4
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Filing Number
Lot Block Lot Area
Building Square Footage
Number of Stories
Building Height
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Number of Dwelling Units
Numb of Bedrooms/Bathrooms
ii�uwlnlsn/Finished
Basement Sq. Ft.
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Stock Plan Number/Options
RadqLlEnergy
Score/ E-Star/er Door
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Y/ N
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SewerTVp Size
Metered
Type f Heat:
El c Main Breaker Size (Residential Only
Temp
ary Electric Pedes I Requested:
Gas ❑ Electric
Xl50 amp or less ❑ 200 amp ❑ other
Yes ❑ No
n► aA&I ir�aK'RINjhUij W11 (including labor, material, profit) $ 11 S!A.;87. 114
Description of Work:
Job Contac a Phong
Subcontrac or Names:
Electrical
,`i--� f
Framer, 0kn4llr,
Concrete
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.
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a. Signature
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Print Namegrte; Phone < 7 �J',3•QSGYJ
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Dist-rTution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE