HomeMy WebLinkAbout3338 W Prospect Rd - Applications/Basement Finish - 04/30/2003In
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 - Fort Collins, CO 80522-0580 - Phone: 221-6760 - Fax 224-6134
BUILDING PERMIT APPLICATION
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First
Middle Phone
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Street Address Please Specify: LN. DR. CR. WY PL. T CT RD. AVE.
City State Zip Code
Company Name
License Number
Supervisor & Cert. #
L
R
Mailing Address
City
State Zip Code
C5
Phone
Please
Specify: LN. DR.
CR. WY. PL. ST CT. RD. AVE. Zip Code
Subdivision/PUD
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CM
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Filing Number
Lot Block
Lot Area
Building Square Footage
Number of Stories
Building Height
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
Stock Plan Number/Options
Radon
Energy Score/E-Star/Air Sealing/Blower Door
Y/N
N
Water Tap Size
Sewer Tap Size
Metered
_d
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less 11200 amp ❑ other
❑ Yes ❑ No
X r r r (including labor, material, profit) $ GNU
x Description of Work:
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h/a
JVU UU111dGt Name & rnone ;r:
ZoUDcontractor Nantes:
Electrical.% Mechanical
Framer
R
d
Q
Roofing
Plumbing _41,/ k"
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 G, T �ei s Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE