HomeMy WebLinkAbout974 Richmond Dr - Applications - 01/23/20044I
City of Fort Collins
BUILDING PERMTFS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
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Street--lAddress ase Specify: LN. R. WY PL. ST CT. RD. AVE. City / State Zip Code
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Gemvaay Name cense Number Supervisor & Cert. #
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Mai'ng A dress City St to U Zip Code
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Please Specify: L MR. WY. PL. ST CT. RD. AVE. Zip Code
JOB SITE ADDRESS
Subdivision/PUD
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Filing Number Lot Block Lot Area
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Building Square Footage Number of Storie, uilding eight
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Number of Bedrooms/Bathrooms Finished Basement Square Footage--
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Value of Construction (including labor, material, profit) $
Description of Work: �}
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Subcontra rs:
Electrical _� [over— Mechanical C lumbing LLn�
Roofing Concrete Framer
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 and city ordinances and state laws regulating building construction.
Signature
Print Name ::'
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Phone Z 'R 2 — �?6O p
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE