HomeMy WebLinkAbout6809 Ivy Glenn Way - Applications/Single Family New - 03/03/2004BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last First
Middle Phone
C� �Ovvt
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C)Street
Address Please Specify: LN. DR. CR. WY PL. STT I RD. AVE.
City State Zip Code
5� C 300
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Company Name License Number
Supervisor & Cert. #
R
Mailing Address City
State Zip Code
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CJ
Phone
303 323
Please Specify: LN. DR.
CR. WY. PL. ST. CT. RD. AVE. Zip Code
Oa .fit, 61 --�
Subdivision/PUD j
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CD
Filing Number Lot Block
Lot Area
Building Square Footage ` S Number of Stories
Building Height
3b
Number of Dwelling Units Number of Bedro /Bathrooms Unfinished/Fin1�shed Basement Sq. Ft.
7y 1
a.
0
Stock Plan Nu ber/Options Radoa_
13 S 1
Energy Score/ E-Star/ Air Sealing/Blower Door
Y( N
!�> I C) W e
Water Tap Size Sewer Tap Size
Metered
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑ Electric
IW150 amp or less ❑ 200 amp ❑other
'-i1�'Yes ❑ No
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Description of Work:
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Job Contact Name & Phone #:
Subcontractor Names:
Electrical S eC�-r C_ Mechanical Lm'O'T-eya-1 1Q)-t Plumbing
Framer ko" cx ,� JJ-,,--SRoofing U! &mob,,,ll Befy,, 14 Concrete n
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.
R
w
-a Signature
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Print Name ' ''� C-) C-- L ''2— Phone 3 O 3 3 2-3 l 3 3
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE