HomeMy WebLinkAbout3403 Green Spring Dr - Applications - 01/29/2003BUILDING PERMITS & INSPECTIONS DIVISION
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P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
CityofFort Collins BUILDING PERMIT APPLICATION
Last
First Middle
Phone
CD
CD
Address Please Specify: LN. DR.
CR. WY PL. ST CT RD. AVE. City
State Zip Code
Compa9 .NarOe
_ License Number,
Supervisor & Cer . #
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Mailing Address // City / / s1G10
33 f<LC d. /l! For`kLo/lj *
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Phone
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Cell 2 2- 0029
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Please Specify:
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LN. DR. CR. WY. PL.
G S
ST CT. RD. AVE. Zip Code
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rG e �—
Subdivision/P f /
a,
S# f ILe
Fill'
Fill' g Number / Lot
Bloc Lot
ea
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Building Square Footage
Number of Sto ies
Building Height
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/moo
z 8
Number of Dwelling Units
Number of Bedr oms/B throoms
Unfinished/ I ' t.
ne
2
y
C.,
Stock PI r/Options
Ran
- ar/Air Sealing/BI r
Y
Ca
Water Tap Size �Sewer
-
Tap SizN
21
Metered
Type o eat:
Electric Main Breaker Size VO' ntial Only)
Tempora ectric Pedestal Requested:
1VGas ❑ Electric
❑ 150 amp or less0 amp❑other
es ❑ No
w:���lai�laKg►tiy�ait��Ul�■ (including labor, material, profit) $ 22 603,70
Description of WorN
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Job Contact N & Phon #:
� 77��)�o4L -- Z27-y7G� �� �alc, 2-29
Subcontractor Nam s: Qn
Electricalg�,� Mechanical / Da.dre V,// Plumbing — 11911Z
Framer own w��f Roofing Px �ncr,
Concrete eI".fp�-,
coay Debtnow
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 a d city ordinance and state laws regulating building construction.
R
w
Signature
CL
Print Name /71 G ire . / (— v I iw' ` Phone 22,6 20�v-1227-W
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE