HomeMy WebLinkAbout2206 Charolais Dr - Applications - 03/19/2004City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
Last First Middle
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3 Street Address Please Specify: LN.dWCR. WY. PL. ST. CT. RD. AVE. City
Company Name License Number
t5 Mailing Address City
Please Specify: LN. D CR. WY. PL. ST CT RD. AVE.
JOB SITE ADDRESS
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Subdivision/PUD
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5 1 Filing Number
Lot Block
= Building Square Footage
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Number of Bedrooms/Bathrooms
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Number of Stories
State
Phone
State Zip Code
Supervisor & Cert. #
Lot Area
Finished Basement Square Footage
Zip Code
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Building Height`
T/W r/
Value of Construction (including labor, material, profit) $ -
Description of Work:
Subcontractors:
Electrical i~� Mechanical
Plumbing ,y�
Roofing Concrete l % ramer
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I hereby acknowledge th t I have read application and state that the above information is correct and agree to comply with all
requirements contain he c' ord' s and state laws regulating building construction.
Signature ,1
Print Name s "� /f slr� Phone
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE