HomeMy WebLinkAbout514 Peyton Dr - Applications - 08/25/2003aIF
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80SM-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last
First
Middle Phone
CD
bAq
c
Street Address Please Specify: LN.
DR. CR. WY. PL. ST CT. RD. AVE.
City State Zip Code
Y1
l
Company N me
License Number
Supervisor & Cert. #
o
Mailing Address
City
State Zip Code
iPhone
Please Specify: LN. DR. CR.
WY. PL. ST CT RD. AVE. Zip Code
Subdivision/PUD
CM
Filing Number d Lot
Block Q
Lot Area
Building Squarq Footage
Number of Stories
Building Height
'
Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinis ed ish d Basement Sq. Ft.
�
�0 1
Stock Plan NO er//0 tions
t
Rad
Energy Score/ -Star/Air Sea li g/Blower Door
Y / N
Water Tap Size
Sewer Tap Si zQ
Metered
N
L l i
GG�61 �f
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑ Electric
150 amp or less ❑ 200 amp ❑ other
Yes ❑ No
(including labor, material, profit) $
Description of Work: ,�,A A , _ _ , _ _
Job Contact Name & Phone #:
Subcontractor Names
Electrical H114
Framer
Mechanical i Plumbing
A I n �_
Roofing
Concrete l)JS Gc A,�dLA ov
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 erein and city or 'nanc and state laws Itifating building construction.
R
-a Signature
a 1
Print Name Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stornnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE