HomeMy WebLinkAbout2050 International Blvd - Applications/Mobile Home - 07/08/2003 (2)c
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.ty of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last First Middle
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Street Address Please Specify: LN. DR. CR. WY PL. ST. CT RD. AVE. City
pany
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Phone
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cense Number
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Phone
4 193- lea16S
Zip Code
CD
r & Cert. #
Zip
Please
Specify:
LN. DR. CR.
WY. PL. ST CT. RD. AVE. Zip Code
Subdivision/PUD
0
k
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Filing Number
Loth
Block
Lot Area
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4 oZ
Building Square Footage
Number of Stories
Building Height
0
130
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
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Stock Plan Number/Options
Radon
Energy Score/E-Star/Air Sealing/Blower Door
Y/N
Water Tap Size
Sewer Tap Size
Metered
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Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑Gas ❑Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
1 1 1 (including labor, material, profit) $ �y
Description of Work:
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Job Contact Name & Phone #:
Subcontractor Names -
Electrical lzwew ���/,�� 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 contoed herein and City ordinAnces and state laws regulating building construction.
R
a Signature
CL
Print Name
L\ Phone 007—
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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