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HomeMy WebLinkAbout526 Peyton Dr - Applications/Single Family New - 07/23/2004im City of Fort Collins BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134 Www.fc'gov.com BUILDING PERMIT APPLICATION rt r.1 lNomes I —t-,� C,, 7 WIP _ 16 D i c Street Address ll�se Specify., LN. DR. C . WY. PL. ST CT RD. AVE. State Zip Code jjPa 1 1 5 VLF^ � Vc� i ,citcy� W� S i7'wi YlS co �© o). Company Name icense Number G �' J Supervisor & Cert. # o W cc Mailing Address City State Zip Code a C.3 Phone Please Specify. LN. DR. CR. WY. PL. S1 CT. RD. AVE. Zip Code IE � 19- Subdivision/PUD � ? � FilingNumber LotBlock Lot Area S 0 S� Building Square Footage Number of Stories Building Height 0 © 2 01� L Number of Dwelling Units Number of Bed ooms/Bathrooms nfinishe finished Basement Sq. R. f a, o Stock Plan Number/Options Radon Energy Score/ E-Star/Air Sealing/Blower Door ? $ q Y /® A ItL SEAL Water Tap Size3 / r Sewer Tap Size Metered Type of Heat: T Electric Main Breaker Size (Residential Only) Temporary Electric Pedestal Requested: Gas ❑ Electric 150 amp or less ❑ 200 amp ❑ other Yes ❑ No i (including labor, material, profit) $ 19 fi p �'- uescnpnon or worK: 191 ai rt Job Contact Name & Phone #: Subcontractor Names: ' Electrical 14 S (LIe-C,`VI c-- Mechanical 91)OSOVA uk ., 1 ✓15 Plumbing Q..4-+C /:;qkjo Framer V., 1=Y'Gtrr� Y�9 Roofing ��,�,VO-�C� � Concrete _� k AA 11". tl II 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. 'a Signature Print Name L. j cy"k.-10 Phone Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE