HomeMy WebLinkAbout2150 Clipper Way - Applications - 11/15/2004BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
www.fcgay.com
cgay.com
gh BUILDING PERMIT APPLICATION
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c Street Address Please Specify., LN. DR. CR. WY. PL. ST. CT. RD. AVE.
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S p rvisor Ce .#
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Mailing Address
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Specify- LN. DR. CR. WY. PL. ST. CT. RD. AVE. �j�Zip Code
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Filing Number
Low
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Lot Area
0
Building S uare Foo a e
Number of Stories
Building H ' htf(
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N
Number of D elling Units
Number�f B r o rooms finishe i ' hed Basement Sq. R.
Stock
P! n WIlLm r Options
Radon
Energy Score Air Sealing/Blower Door
Y/
Water Tap Size (/
Sewer Tap Size
etere
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Type f Heat: I
I Electric Main Breaker Size (Residential Only)
Temporary ElectricPedestal Requested:
Gas ❑ Electric
LA150 amp or less ❑ 200 amp ❑ other
es ❑ No
. # �incauuing woor, material, profit) $ ((o (, l CCq- `1 u
Description of Work. ,
Job Contact Name & Phone #:
Subcontractor Na es: 9
Electrical Mechar
Framer Roofing
a
a
4-72 M 21G'
Concrete
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
naand
dccity ordinances and state laws regulating building construction.
Sign a e t
Print Name
Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPUCAnON EXPIRES 180 DAYS FROM APPUCAnON DATE