HomeMy WebLinkAbout3507 Kingsley Dr - Applications/Patio Cover Or Sun Shade - 05/07/2004Bun nnvG PERMf15 & INSPECTIONS Driri m
EQ Sox SW • Fort Collins, CO 805 B0 • Phone M-6760 • Fax 22A-61M
BUILDING PERMIT APPLICATION
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Street Address Please Specify., LN. DR. CR. WY. PL. ST. CT RD. AVE. City State Zip Code
3 50 7u1 ��
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Company Name License Number Supervisor & Cert. #
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Mailing7 Address Ci State Zip Code
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Phone
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Please Specify: LN. DR. CR. WY PL. ST RD. AVE. Zip Code
A
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division/PUD
0 350 R• llms S s
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Filing Ajumbg Lot U Block Lo Area
Building Square Footage Number of Stor' Building Height
— 1% S
LNumber
of Dwell' Units Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
Stock Plan Number/Options Radon Energy Score/ E-Star/Air Sealing/Blower Door
Y/N
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Water Tap Size Sewer Tap Size Metered
_d
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
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(including labor, material, profit) $
Job Contact Name & Phone #: SQlf✓1 �)0 :3 . q31 ' 0 9 3S
Subcontractor Names: L/
Electrical 6xP fE!I e6—t C Mechanical Plumbing
Framer
Roofing
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 contai ed herein and city ordinances and state laws regulating building construction.
06 Signature
Print Name / S Phone !?20 � S6 7 • %8 fJ
Distribution: white — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS MOM APPLICATION DATE