HomeMy WebLinkAbout1136 E Stuart St - Applications - 08/07/2003BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
(10970 ""*�)
City of Fort Collins BUILDING PERMIT APPLICATION
Applfcatfon'Mamber APIWcation pate
Last First Middle
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c Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. City State
Company Name License Number Supervisor & Cert. #
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R Mailing Address City St
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Phone
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Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE.
JOB' SITE ADDRESS
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Subdivision/PUD
Filing Number Lot
Building Square Footage
Number of Bedrooms/Bathrooms
Block
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Phone
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Zip Code
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to Zip Code
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Lot Area
Number of Stories
2—
Finished Basement Square Footage
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Building Height
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Value of Construction (including labor, material, profit)
Description of Work:
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Subcontractors:
Electrical ,-}�„Cjo Mechanical &%q— Plumbing A�cN
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Roofing '-k/., Concrete tv/C., Framer
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
require ed herein and city ord' s and state laws regulating building construction.
cca Signature
Print Namet-� , .� Phone i7U '�,' 01 G p
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE