HomeMy WebLinkAbout633 Stonington Ln - Applications - 06/11/2004City of Fort Collins
BUILDING PERMITS & INSPECTIONS DMSION
P.O. Box 580 • Fort Collins, CO 8052M580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last
First
Middle Phone
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Street Address lease Specify LN. DR. CR. WY PL. ST CT RD. AVE.
City State Zip Code
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Cppany Name
License Numb r
Supervisor & Cert. #
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Mailing Address
City
State Zip Code
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Phone
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Specify: LN. DR. CR.
WY PL. ST. CT. RD. AVE. Zip Code
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Subdivision/PUD
CM
Filing Number
Block
Lot Area
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ree Footage
BuildingVa--l
Number of tories
Building Height
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of Dwelling Units
Number of Bedrooms/Bathrooms nfinished 'nished Basement Sq, Ft.
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0
Stock Plan Number/0 tions
P
`'� W — 3 �`
Radon
Energy Score/ Sealing/Blower Door
Y/ N
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.Sewer
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Water Tap Size
Tap Size
Metered
LD
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
MGas ❑ Electric
IM 150 amp or less ❑ 200 amp ❑ other
99 Yes ❑ No
MrCt11rtaluiKU@!.'i�atlyutl►■ (including labor, material, profit) $—
Description of Work:
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you contact Name & Phone #:
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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.
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aSignature
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Print Name Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE