HomeMy WebLinkAbout5132 Fruited Plains Ln - Applications - 04/28/2004BUILDING PERMM Ac INSPECTIONS DIVISION
P.O. Box 58o • Foit Collins, CO W522-ON * Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
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Street Address Please Specify., LN. CR. WY. PL. ST. CT RD. AVE.
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Mailing Address / City State Zip Code
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Phone
Please Specify: LN. R. CR. WY. PL. ST CT RD. AVE. Zip Code
JOB SITE ADDRESS
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Filing Num er
Lot Bloc
Lot Area
Building Square Footage
Number of Stories
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Number o Dwelling Units
Number a ms/Bath Dms
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Stock Plan Number/Options
Radon
Energy
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Water Ta 'ze
ewer Tap Size
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Type of eat:
Erectric Main Breaker Size IResidential Only)
Temporary Elec
as t7 Electric
50 amp or less ❑ 200 amp ❑ other
❑ Yes 99
r + (including labor, material, profit) $
Description of Work: 0
Pedestal Requested:
Job ContactTlame &Phone #:
�- /�!/14 4 70- 5'(o 7- oS'YV
Subcontractor Names:
Electrical CA44wr <lc _ Mechanical Gp Plumbing
Framer )4::'je4— Roofing ��/d Concrete L
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
W I • requirements cogtaiped herein and city ordinances and state laws regulating building construction.
'& I Signature
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Print Name f5eet---44-A. (4 /LIn Phone �ib3 — g y6 -8S3Z
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE