HomeMy WebLinkAbout2000 Stover St - Applications - 03/04/2003City of Fort Collins
BUILDING PERMrrS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
First
Middle Phone
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Last
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Street Address Please S cify: LN. M. CR. WY. PL. ST. CT RD. AVE.
City State Zip Code
F
Co Co 905D S
Company Name
License Number
Supervisor & Cert. #
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Mailing Address
City
State Zip Code
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Phone
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Please
Specify: LN. DR. CR. WY. PL. ST CT RD. AVE. Zip Code
Subdivision/PUD
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Filing Number
Lot Block
Lot Area
Building Square Footage
Number of Stories
Building Height
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement
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/
8
Stock Plan Number/Options
Radon
Energy Score/ E-Star/AirSealing/Blow
Y/N
MIA
Water Tap Size
Sewer Tap Size
Metered
y
N
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
(including labor, material, profit) $
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Description
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Job Contact Name & Phone #: Ties sy--A-e.*v, :s Si-c r— - vtck:ve— em1y
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Subcontractor Names:
Electrical 6-7Iavtz- P" Mechanical Plumbing N%!g
Framer NIA- Roofing 1114 Concrete A/
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contain In and city ordinVpSs and state laws regulating building construction.
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a. Signature
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Print Name16 Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE