HomeMy WebLinkAbout2832 Outrigger Way - Applications - 07/10/2003City of Fort Collins
BUILDING PERMITS & INSPECTIONS DMSION
RO. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-61M
BUILDING PERMIT APPLICATION
Last
First
Middle Phone
KB tic> ME
03 323 1133
c
Street Address Please Specify: LN. DR. CR. WY. PL. ST CT. RD. AVE.
City State Zip Code
t9 5 300
JUN (..
Company Name
License Number
Supervisor & Cert. #
o
- 373
105
Mailing Address
City
State Zip Code
5AM
6
Phone
30 3 13
Please
Specify: LN. DR. CR.
WY. PL. ST CT. RD. AVE. Zip Code
Z832
Subdivision/PUD
C
D's
K -
Filing Number
Lot Block
Lot Area
1
170
Building Square Footage
Number of Stories
Building Height
o
511
Z . S
' M qx
Number of Dwelling Units
Number of Bedrooms/Bathrooms nfinishe ished Basement Sq. Ft.
Stock Plan Number/Options
Radon
Energy Score/ E-Star/Air Sealing/Blower Door
37 I 8 3 Y /d
6LAOLJ
Water Tap Size
Sewer Tap Size
Metered
W
_
3 . _<
<.
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
WGas ❑ Electric
1<150 amp or less ❑ 200 amp ❑ other
es ❑ No
1 1 ► 1 ► fineludinn lahnr_ material_ nrnfitl $
, — ob—Q •-Ym
Description of Work:
12'LAQ4 335, 151�t
3 cAp, c&ARA(.E
Job Contact Name & Phone #:
KtAt6 HEMP 4�10 5�27 51TS
Subcontractor Names:
Electrical S 5 t_�cY�1c Mechanical A)R pRobucTS Plumbing pA7y,tcK
Framer D+R IrpAM11M(, Roofing cAM4PgELL BC-Ak> Concrete :34C F'oc��?DQ►jo/JS
cc
a
o.
a
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.
Signature
4-, CL 1M
Print Name -" r)--4 fy*\ 0 E L� � Phone 3c--., 3 32- 3 l ( 3 3
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE