HomeMy WebLinkAbout7318 Streamside Dr - Applications - 04/10/2003BUILDING PERMITS Bit INSPECTIONS DIVISION
r
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
CityofFort Coffins BUILDING PERMIT APPLICATION
40=04 Number Application Date
Las First Middle
Phone
_5
ZM3-fo`�'�I
c
Street Address Please Specify: LN. DR. CR. WY PL. ST CT RD. AVE. City
State Zip Code
Company Name License Number
Supervisor & Cert. #
0
lsuk1LIERSgZUL t> 371
104$
t5
Mailing Address Cit State
Zip Code
0
Phone
Please Specify: LN. DR. CR. WY PL. ST CT RD. AVE.
Zip Code
JOB SITE ADDRESS ri.'� t
Subdivision/PUD
CM
-S E
Filing Number Lot Block Lot
Area
211-- 33
jz!�
Building Square Footage Number of Stories
Building Height
0
L
Number of Bedrooms/Bathrooms Finished Basement Square Footage
0
v
Value of Construction (including labor, material, profit) $ Z
Description of Work:
A V-O�V, � -r2A- 2 ,P +- ?i►e"oc. 6,0jeVyy,.,
Subcontractors:
jj
Electrical f f�y�S 't-C..G 12k Mechanical
Plumbing
RoofingQNR-)i V. F--Q f6KA Concrete 4"lLbEVL.,
Framer ��i1�-r�k '►i!� l
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.
c
R
'o. Signature
a
Print Name GrEWE 62-4�n Phone Li
Distribution: Original - L & P Yellow - Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE