HomeMy WebLinkAbout2833 Chase Dr - Applications - 03/22/2004BUILDING 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
CDStreet
Address Please Specify: LN. DR. CR. WY PL. ST. CT. AVE. City State
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Zip Code
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Company Name License Number Supervisor & Cert.
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Mailing Address Cityy � State
,Zip Code
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Phone OCR o9�
Please Specify: LN. CR. WY. PL. ST. CT. RD. AVE.
Zip Code
z 8-33 C ,S� F -:Za,,' `r v-5 GU
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Subdivision/PUD
Filing Number Lot Sg Block Lot Area SO .
Building Square Footage`z Number of Stories
Building Height ,
0
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Number of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/Finished
Basement Sq. Ft.
VJ
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Stock Plan Number/Options Radon <nerg Sc
E-Star/Air Sealing/Blower Door
/N
Water Tap Size %/ Sewer Tap Size
Metered
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑ Electric
49150 amp or less ❑ 200 amp ❑ other
Yes ❑ No
r r r (including labor, material, profit) $
Job Contact Name & Phone #:
Subcontractor Names: `
Electrical Yja— ,./� /' �1��/iL Mechanical ✓•��vic� �;47�,P�A7"5 Plumbing��e/'S _' -,
Framer 64fj"��`r Roofing
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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 contained herein and city ordinances and state laws regulating building construction.
R
'a Signature
Print Name i- 7"a1<,94 Phone
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Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE