HomeMy WebLinkAbout1220 Catalpa Pl - Applications - 01/23/2004City of Fort Collins
BUILDING PERMITS & INSPECTIONS DMSION
P.O. Box 580 • Fort Collins, CO 8052M580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last
First Middle Pfione
CD
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.REF Y -193 -301a (M0 33 4
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Street Address Please Specify: LN. DR. CR. WY PL. ST CT. RD. AVE. City State Zip Code
Pa!,M664 DR
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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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Specify: LN. DR. CR. WY. PL. ST. CT. RD. AVE. Zip Code
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11'
Subdivision/PUD
CM �a
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Filing Number
Lot Block Lot Area
Building Square Footage
Number of Stories Building Height
3
Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
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Stock Plan Number/Options
Rado Energy Score/ E-St Air Sealin lower Door
Y rN
Water Tap Size 3
Sewer Tap Size Metered
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Typ�fe of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑Electric
J150 amp or less ❑ 200 amp ❑other
WYes ❑ No
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1 1 1 (mcludmg labor, material, profit) It Q�
Description of Work: V
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Job Contact Name & Phone #:
,-)EFF DAy15 q?a- e�90-3642
Subcontractor Names: ,1
Electrical >�n EC,CG�2� Mechanical Ct)=AA HG� 4 Ax Plumbing P 4 21 VLUM 13 JAJ
Framer DA-u (5 aA-),-T 2, Roofing T)au IS ("OJLJ.52AUCT�, Concrete _ plm c to (",0)1C.
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.
R
-a Signature
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Print Name s-FF DAu15 Phone 620 -36y2 Q23-5017
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE