HomeMy WebLinkAbout6220 Tilden St - Applications - 03/08/2004BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last
First Middle
7 Phone
L
CDStreet
Address Please Specify-
Company Name
LN. DR. CR. WY PL. ST CT RD. AVE. City
�icense Number
State Zip Code
Supervisor & Cert. #
0
ailin Address
city State
Zip Code
�
Pone
_ 5 9 IN _O
Please
Specify- LN. DR. GR. WY PL.
ST CT RD. AVE. Zip Code
Subdivision/PUD
CC
O1
°;
Filing Number
Lot Block
rea
0
Building�q�are Footage
Number of tories
Building Hight
LNumber
of Dyvelling Units
Number o B Brooms/Bathrooms
Unfinished inish d asement Sq. Ft.
N
`
-�
C,
Stock Plan Number Options
Rad
Energy Score/E-Star/Air Seali Blower Door
Y 4 N
W
CDID
Water TapSize� t1
SewerTapSiz
Metered
.L
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temp rary Electric Pedestal Requested:
as ❑ Electric
❑ 150 amp or less 200 amp ❑ other
es ❑ No
01
��hl�lll]��Ii ► 101411111211 (including labor, material, profit) $ d
Description of Work:
Subcontractor Names:
Electrical Mechanical �) k �- Plumbing
Framer Roofing �(,, Concrete Lm�"A (�Mo
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements ntained herein and city ordinances and state laws regulating building construction.
R
-a Signature
o. 2 �—
a b
Print Name � Y\ �'e—S-�cb�� � Phone Z U �, La
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE