HomeMy WebLinkAbout3914 Mesa Verde St - Applications - 04/20/2004BUILDING PERMITS & INSPECTIONS Divism
Aik P.O. Box 5S0 - Fort Collins, CO 805224M - Phone: 221-6760
Cityof Fort Collins BUILDING PERMIT APPLICATION
c Street Address Please Specify: LN. DR. CR. WY. PL. S1 CT. RD. AVE.
/ — EaCOE .ST
Company Name License Number
R Mailing Address City
1F-v 3 lr-�nr
`A Phone
.5 68
Phone
City State Zip Cade
cz�.'Ws Co J10-5-457
Supervisor & .0 # X*ik;ry A, 'j'd4
Zip
Please Specify: LN. DR. CR. WY. PL. ST CT. RD. AVE. Zip Code
JOB SITE ADDRESS 3Y/ti/ae5,a (/coma- ST' �C7-- COLLI 5, CO �oszs-
auoaivision/ruu
C" b,
°i Filing Number Lot Block Lot Area
1
Building Square ootage Number of Stories Buildin Height
C-/xr sn�;z
Number of Bedrooms/Bathrooms Finished Basement Square Footage
l
Value of Construction (including labor, material, profit) $
Description of Work:
OF— /zr3�/J�/7'9.4L R.4=�rM Er,PT
Subcontractors:
Electrical M,414.gs 6" Mechanical 7"%�_11 Plumbing XA
Roofing �,l Concrete f Framer _Mnal4e, artsr
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contlaine in and city ordinances and state laws regulating building construction.
R
a Signature --CL
— _
c p
Print NameC lww4e' Phone
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE