HomeMy WebLinkAbout2626 Pasquinel Dr - Applications - 08/27/2003BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 - Fort Collins, CO BOSM-0580 - Phone: 221-6760 - Fax 224-6134
BUILDING PERMIT APPLICATION
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First
Middle
Phone
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Street Address Please Specify: LN. DR. CR. WY. PL. ST CT. RD. AVE.
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City State
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Zip Code
8052&
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License Number
Supervisor & Cert. #
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Mailing Address
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City
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State
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Phone D Le
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Filing Number
Building Square Footage
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Number of Dwelling Unit
Stock Plan Number/Optic
Water Tap Size
Type of Heat:
brGas ❑ Electric
Description of Work:
ease Jpeary: LN. DR. CR. WY. PL. ST CT RD. AVE.
Ho t:y
Block
Number of Stories
Number of Bedroc
3
Radon
Y/N
t 5--/-7,yt
-7�
Energy
S/C
Building Height
Electric Main Breaker Size (Residential Only) Temporary Electric Pedestal Requested:
);(150 amp or less ❑ 200 amp ❑ other 1 ❑ Yes XNo
(including labor, material, profit) $ R,5, ofv
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Job Contact Name & Phone #:
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Subcontractor Nam s:
Electrical _ (U -- Mechanical %i4' Plumbing
Framer _ Roofing f Concrete
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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 nd city ordinance and state laws regulating building construction.
Signature
Print Name C.--f'� Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE