HomeMy WebLinkAbout831 Benthaven St - Applications/Basement Finish - 10/11/2004BUILDING PERMITS &L INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com
City of Fort Collins BUILDING PERMIT APPLICATION
Application Number -13 D 6�O 6:5 VJ Application Date to ,1 I /-Q
Last First
A1i4
0 3 Street Address Please Specify: LN. DR. CR. 1
F3/ �3- (7-77AJY-t-�4,4 4)
Company Name
Middle
/TZ-
VY TL. ST CT. RD. AVE. City
�.
License Number
Phone
State Zip Code
Supervisor & Cert. #
L
O
A Mailing Address City State Zip Code
L
C
Phone
Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE. Zip Code
JOB SITE ADDRESS
Subdivision/PUD
ia r=0uieCM
SQL SD 5 �I
Filing Number Lot
)4 j S5
Building Square Footage
Number of Bedrooms/Bathrooms
0
t�
Block
Number of Stories
Lot Area
Finished Basement Square Footage
.f.7 lBi'
Building Height
Value of Construction (including labor, material, profit) $
Description of Work: !Description of Work:
NA��
IR
in
Subcontractors:
Electrical /�/dyJPPR Mechanical e�p k(jhe Plumbing 5-
Roofing Concrete Framer
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 cit ordinances and state laws regulating building construction.
R
v
-a Signature
Q.
a
Print Name Phone
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE