HomeMy WebLinkAbout7445 Matheson Dr - Applications/Single Family New - 07/07/2004BviwiNG PEBMTI'S & INSPECTIONS DIVISION
P.O. Box 580 • Fort Colons, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
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cStreet Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. City State Zio Co
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License Numb r
Supervisor & Cert. #
Mailing Address
City State Zip Code
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Phone
Please Specify:
LN. DR. CR. WY. PL. ST CT RD. AVE. Zip Code
R
Subdivision/PUbCM
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3
Filing Number 3 of
31,9
Block
Lot Area
S
Building Square Footage
Number of Stories
Building Height
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tr
Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
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3
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Stock Plan Number/Options
Radon
Energy Score E-Star/AirSealin Blower Door
Y N
jH2 SEGt
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Water Tap Size It
Sewer Tap Size
Metered
m
K
Type of Heat:
Ele tric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑ Electric
150 amp or less ❑ 200 amp ❑ other
Yes ❑ No
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Description of Work:
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ion contact Name & Phone #: 11
Subcontractor Names:
Electrical R ► N �- I il1ij) �C_ Mechanical �S t'b So Plumbing
Framer I, g L Fo. v%-, r1a Roofing V etd t9V T" Concrete
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0
0
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
Print Name 4V Vv Phone 3"03 — f
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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