HomeMy WebLinkAbout3814 Little Dipper Dr - Applications/Single Family New - 03/24/2004y'
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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Street AddreSsPlease Specify: LN. DR. CR. WY PL. ST. CT RD. AVE. City
State Zip "Code
Co any Name
Lice se umber
Supervi o & Cert. #
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Mailing Address
City State
Zip Cade
Phone
Please Specy: LN. DR. CR. WA�Y ssPL.
ST CT RD. AVE. ff Zippc Code
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Filing Number
Lot Block Lot Area
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Number of Stories
Building Height
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Number of Be rooms/Bathrooms
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Stock Plan Numbe tions
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Energy Score/E-Star/Air Se ling/Blower Door
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Wa r Tap Size
Sewer Tap Size „
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Type of Heat:
Electric Main Breaker Size (Residential Only)
7Temp—orary�"Electric Pedestal Requested:
Gas ❑ Electric
50 amp or less ❑ 200 amp ❑ othe'-fes
❑ No
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(including labor, material, profit)
Job Conto Name & PtWne #:
Subcontractor Name : EM
Electrical �L LtU-,A—t�� Mechanical Plumbing
Framer T'r ' C.L ,�"�6,�"/ Ld
Concrete
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I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contai59d herein and city ordinances and state laws regulating building construction.
Signature
Print Name
Phone _-3n'3 — 45; [ K -65c;t 1 f
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE