HomeMy WebLinkAbout2127 Baldwin St - Applications - 02/17/2004BUILDING PERNIM Fit INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522 OSM • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
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-
Coppany Name
Lic nse mber
pervisor Cert. #
Mailing Address
City
"Zip Code
�
hone
Please
Specify: LN. DR. CR. WY. PL.
S1 C1 RD. AVE. Zip Code
'11'
a-7 V)a�atjc-) In St
7031
divi 'on PUD
CM
umber
Lot ck Lot Area
Building Square Foot ge
Number of Stories
Buildin Heiglt
0
Number of Dwelling Units
Number of Bedrooms/Bathrooms
' he ` hed Base ent q. Ft.
L
VJ
Stock Plan Number/Options
adon
Energy Score/ E-Star/Air Sealing/ owerpoor
—�
Y N
Water Tap Size
A
SewerTap ize�l
Meter
d
;r
Type of Heat:
Elect 'c Main Breaker Size (Residential Only)
Te
porary Electric Pedestal Re uested:
as ❑Electric
150 amp or less ❑ 200 amp ❑other
&Ye s ❑ No
(including labor, material, profit) $
j
Description of Work:
Job Contact Name & Phone #: 53N7ea 0_ �Q,� w _ ���EP
Subcontractor Names: lU
Electrical c" Mechanical g anh,, ,s (L) i no Plumbing
Framer
R
Q
a.
a
Roofing
Concrete
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 I
Phone --P50) !) Conco
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE