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HomeMy WebLinkAbout7414 Fountain Dr - Applications - 07/01/2003City of Fort Collins BUILDING PERMITS & INSFECTIONs DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 22"134 BUILDING PERMIT APPLICATION Last First Middle as c Street Address Please Specify: LN. D . CR. WY. PL. ST. CT. RD. AVE. City 11 vi in (A,i' A Co any Name Lic se Number L Mailing Address City State C) I Phone ipervisor & C rt. # Zip Please Specify. LN. DR. CR. WY. PL. ST. CT RD. AVE. Zip Code --7L1 — guHf n: Subdivision/PUD 1 �s C, � Filing Number Lot t Block Lot Area Building Sqre Footage Number of Stories Building Height I tt L Number of Dwelling Units Number of Bedroo s/ throoms Unfinished/ ished Basement Sq. R. C, Sto Plan 4 Nujef/O tions Rad Energy Score/E-Star/Air Sealing/Blower Door t y Air, y Water Tap Size' it Sewer P�Size Metered t Ty f Heat: Elect ' Main Breaker Size (Residential Only) Te or ry Electric Pedestal Requested: Gas ❑ Electric 150 amp or less ❑ 200 amp ❑ other 9QYes ❑ No (including labor, material, profit) $ �q Description of Work: 1l 1V p1eW wI ► t k©t,4. ,�oui, 0 Job Contact Name & Phone #-. Subcontractor Names: Electrical Mechanical ��l bno -h Y Plumbing r Framer �. Cram Roofing kavdaw,' Concrete �>A ,IT R,(,VjMI" 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 hereiVannad ity ordinances and state laws regulating building construction. cc -a Signature a Print Name 64441/61— Phone Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE