HomeMy WebLinkAbout5409 Rabbit Creek Dr - Applications - 08/28/2003BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-61M
BUILDING PERMIT APPLICATION
Last First Middle
Phone
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Address Please Specify: LN. DR. CR. WY. PL. ST. CT. RD. AVE. City
State Zip Code
Corey Name olomp"", IA License Number
Supervisor Cert. #
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Mailing Address Cit State
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Phone
Please Specify: L�N. DR. GR. WY. PL.
ST. CT. RD. AVE. Zip Code
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Subdivision/PUD
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Filing Numb Lot Block Lot Area
Building Sgu FNumber of Stories
Building Height _
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of Dwelling Units Number o edrooms/Bathrooms
of ish ished Basement S . Ft.
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Stock Plan Number/Options Radon
-Star/Air Sealing/Blower Door
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Water TapSize3� �� sewer Ta eii
Metered B�
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Typ f Heat:
Ele tr'c Main Breaker Size (Residential Only)
TemVorary Electric Pedestal Requested:
Gas ❑ Electric
150 amp or less ❑ 200 amp ❑ other
es ❑ No
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Description of Work:
Job Contact NameA Phone #:
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Subcontractor Names:
Electrical fj/BIi� Gcijj-7Z[,� Mechanical /V�1- Plumbing 14&c��Ci
Framer 15�--_o 221 Roofing 60& P "5 Concrete /V8ZC/
I hereby acknowled ve=e"application and state that the above information is correct and agree to comply with all
requirements co ate finances and state laws regulating building construction.
Signature
Print Name CPhone, lS
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE