HomeMy WebLinkAbout2236 Eastwood Dr - Applications/Addition or Alteration - 11/07/2002&\6,
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BUILDING PERMITS & INSPECTIONS DmSION
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P.O. Box 580 • Fort Collins, CO 80522-MOO • Phone: 221-6760 • Fax 224-6134
City of Fort Collins
BUILDING PERMIT APPLICATION
Last
First Middle Phone
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c Street Address Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE. City State Zip Code
Compa y Name
License Number Supervisor & Cert. #
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Mailing Address
it y State Zip Code
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Phone
Please
Specify: LN. DR. CR. WY. PL. ST CT RD. AVE. Zip Code
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Filnvision/
ig Number
Lot Block Area
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30 7
Building Square �eotage
Number of Stories Building Height
Number of Dwelling Units
Number o Be�oms/Bathrooms Unfinished/Finished Basement Sq. Ft. O
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Stock Plan Number/Options
Radon Energy Score/E-Star/Air Sealin Blower Door
Y / N
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WaterTapSize
Sewer Tap Size Metered
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
' 1 1 1 (including labor, material, profit) $ 6
Description of Work:
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Job Contact Name &Phone #:
Subcontractor Names:
Electrical �11�C
Mechanical fuAlrN \jal(ipy ry►r— Plumbing P
Framer ;let5 +oofing cXa i'v� Concrete A:PzPe-r,ir- ,-��..���+71
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.
R
a Signature
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Print Name i , Phone —74 11—
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE