HomeMy WebLinkAbout2837 Michener Dr - Applications - 11/30/2004BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www. fcgov.com
BUILDING PERMIT APPLICATION
City of Fort Collins
Application Number 3 Application Date
Last First Middle Phone
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Street Address P ase Specify: LN. DR. CR. WY. PL. ST CT. RD. AVE. City 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
JOB SITE ADDRESS
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Subdivision/PUD
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Filing Number Lot Block Lot Area
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Building Square Footage Number of Stories Building Height
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Number of Bedr ms/Bathrooms Finished Basement Square Footage
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Value of Construction (including labor, material, profit) $ 0-D 0
Description of Work: FNn
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Subcontractors:
Electrical
Roofing
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Mechanical
Concrete
Plumbing
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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 Phone q7n —2.2.3 �o b
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE