HomeMy WebLinkAbout5132 Cinquefoil Ln - Applications - 06/11/2004BUILDING PERmrrs & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last First
Middle Phone
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Street Address Please Specify: LN. DR. CR. WY PL ST. T. RD. AVE.
City State Zip Code
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Company Name
License Numb`e�
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Supervisor & Cert. #
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Mailing Address City
State Zip Code
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Phone
Please Specify:
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R. CR. WY PL, ST. CT. RD. AVE. Zip Code
Subdivision/PUD
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Number Lot
Block
Lot Area
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Building Square Footage �\
Number of Stories
Building
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�Height
Number. of Dwelling Units
Nu-mmb r of Bedrooms/Bathrooms Unfinished/f4p0ted, Basement Sq. Ft.
Stoc I nNumber/Options
Radon
EnergScore/ E--Star/Air Seal ing/Blower Door
Y/
KlP,N1-tf,3&-''
Water Ta Size
Se a Tap Size Metered
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TypLof Heat:
Elects Main Breaker Size (Residential Only)
Tempos Electric Pedestal Requested:
Gas ❑ Electric
150 amp or less
❑ 200 amp
❑ other
Yes ❑ No
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Description of Work: ,
Job Contact Name & Phone #:
Subcontractor Names:
Electrical �j� L� �C Mechanical Plumbing—pU��C���j
Framer Roofing ES��i=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 contained he and ci ordinances and state laws regulating building construction.
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Print Name Phone �Jbt)
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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