HomeMy WebLinkAbout630 Blue Mesa Ave - Applications/Addition or Alteration - 10/14/20027k 4�Ic
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City
of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-05M • Phone: 221-6760
BUILDING PERMIT APPLICATION
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Phone
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Street Address Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE. City
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State Zip Code
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Company Name License Number Supervisor & Cert. #
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Mailing Address City State
Zip Code
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Phone
Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE.
Zip Code
JOB
SITE ADDRESS � 17,111
Subdivision/PUD
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VA/00
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Filing Number Lot Block Lot Area
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101972
Build' Sq are Footag Number of Stories
Building Height
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Number of Bedrooms/Bathrooms Finished Basement Square Footage
Value of Construction (including labor, material, profit)
Description of Work:
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AV -i ler" & f % 101 Reyse E+, sf+�g 9,g ij-v5$
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Subcontractors: /' j I
Electrical Srf Mechanical 5elr Plumbing akar Plum 6)-ki
Roofing _eV Concrete 5 -e (r— /UQ%1/e Framer 5�0-/
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements c,"ined herein and city ordinances and state laws regulating building construction.
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Signature
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Print Name J J U/ rV J I/.
Phone da (, - 5a 3?
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE