HomeMy WebLinkAbout5050 Brookfield Dr - Applications - 05/05/2003-L - 3z
BUILDING PERMITS & INSPECPIONs DmSION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-61M
BUILDING PERMIT APPLICATION
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Please Specify: LN. DR. CR,
PL. ST. CT. RD. AVE.
City
State
Zip Code
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LN. DR. CR.
WY. PL. ST. CT. RD.
AVE.
Zip Code
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Number of Stories
Building Height
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Num er of welling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. R.
Stock Plan Number/Options
Radon
Energy Score/E-Star/Air Sealing/Blower Door
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Sew rTa Size
Metered
Type of Heat: Wit-
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
150 amp or less ❑ 200 amp ❑ other
❑ Yes No
WA (including labor, material, profit) $
Description of Work:
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Job Contact Name & Phone
21
Subcontractor Names: I
Electrical CY Mechanical Plumbing Y
Framer C I _ rA, / (,Lf'tQ Roofing r/f )14_0,ijjff 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 h and city ordin rites and state laws regulating building construction.
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Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE