HomeMy WebLinkAbout708 Keenesburg Ct - Applications/Single Family New - 03/02/2004City 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
Last First Middle Phone
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Addr Please Specify: LN. DR. CR. WY PL. ST CT RD. AVE. City State Zip Code
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a License Number Supervisor & Cert. #
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Please Specify: LN. DR. CR. WY PL. ST. CT RD. AVE. Zip Code
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Filing Number, Lot Block L5�6,;-L
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Building �aarree_Footage Number.Qf Stories Building Hei ht
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Number of Dwelling Units Number o Bedrooms/Bathrooms 54=7Finished Basement Sq. Ft.
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Stock Pla Number/Options Radon Energy Score/E- tar/Air Sealing/Blower Door
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TapSize Sewer Tap Size Metered
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Type of Heat:
Electric Main Breaker Size (Residential Only)
Tem orary Electric Pedestal Requested:
Gas ❑ Electric
150 amp or less ❑ 200 amp ❑ other
Yes ❑ No
�rrt��lai�la[KIRKINf1lyIII] j (including labor, material, profit) $ � 7a
Description of Work:
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Job Contact Name &Phone #:
UIa.n C9'70> 41�- 5-V�
Subcontra for Names. �c
Electrical } � `Gl£C �t G Mechanical '1 LEW � li Plumbing
Framer )�1 L lk().!M l (",\0 Roofing avxc-6 I�04t &Concrete 6*)
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
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requirements contained herein and city ordin ces and state laws regulating building construction.
a Signature
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Print Name
Distribution: White — Office Yellow Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE