HomeMy WebLinkAbout2868 Pleasant Valley Rd - Applications - 05/07/2004Last
c Street
13
ElumDING Pmtmns & INSSPECTIONs DIVISION
P.O. Box SW • Fork Coffins, CO 8022 MM • Phone: 221-6760 • Fax 22"iM
BUIL i1 G PERMIT APPLICATION
Please Specify. LN. DR. CR. WY. PL. ST CT. RD. AVE.
M
company Name IJ License Number Supervisor &
Mailing Addr ty State
6 Phone
a,46-agH
Please Specify: LN. DR, CR. WY. PL. ST. CT RD. AVE
$(Pg pa v G\
Subdivisio /PUO
Filing Number Lot Rlnrk 1 nt Aran
Building Square Footage
= i 3 a.
i Number of Dwelling Unit
Stock Plan Number/Optio
U), _:t
Number of Stories
3 / Q ' s-
�'�' N i0
Water3TapSize Sewer Tap Size
Type of Heat: Electric Main Breaker Size (Residential Only) Temporary Electric
M Gas ❑ Electric R 150 amp or less ❑ 200 amp ❑ other K Yes ❑ No
(including labor, material, profit) $ 1 4y 9cr-? ()-o
Description of Work:
105z1
Zip Code
015 2-1
l�
Zip Code
Building Height
� Ic t
Job Contact Name & Phone #:
S�\S -52, \'yL\1 LK - a91 LA Eyo s V-N U 5 saU cQ17 - V o71- f
Subcontractor Names:
Electrical �a�,��, �\ �c . Mechanical Plumbing
Framer Roofing Concrete \jc.\ k e�A . J
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.
w
a Signature
a �`
Print Name ,�� 1�' Phone y7.z-OISO a 1g-aql
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater 2 g
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE