HomeMy WebLinkAbout7521 Triangle Dr - Applications - 07/14/2004BUILDING PERMIrrs & TNSPIECTIONS DIVISION
P.O. Box 580 • Fort Coltinc, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
www.fcgm.com
BUILDING PERMIT APPLICATION
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Street Address Pleasd Specify: LN. DR. CR. 0 PL. ST. CT. RD. AVE.
Clty State Zip Code
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Company Name License Number
Supervisor & Cert. #
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Mailing Address City
State Zip Code
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Phone
Please Specify: LN. DR.
CR. WY PL. ST CT RD. AVE. Zip Code
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Filing Nu er Lot Block
Lot Area
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Building Square Footage Number of Stories
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Buildi�ejjght,,
Number o�Dweiling Units Number ofBedr oms/Bathrooms Unfinishe Finished Basement Sq. Ft.
Stock Plan Number/Options Radon
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Energy Sc-Star/Air Sealing/Blower Door
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WaterTapSize IewerT g1
3` l I Size
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Metered
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Type of Heat: Electric Main Breaker Size (Residential Only)
Tem ovary Electric Pedestal Requested:
Gas ❑Electric 150 amp or less 103120 0 amp ❑other Yes ❑ No
(including labor, material, omfit) S
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Description of Work:
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Job Contact Name & Phone #: _
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Subcontractor Nam s:
Electrical f4 tC C_Mechanical �I gSOJ a
umbing 46 1T UY."fI P t� f✓t
Framer K I L FR-AL--t Roofing 140V {INL�,o (? 0p(--1 N� Concrete ti S F-0u W fl A7 O
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
19 requirements contained herein and city ordinances and state laws regulating building construction.
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'Q Signature
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Print Name - Phone 3—G4 (,.34a =ts
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE