HomeMy WebLinkAbout4144 TIMBERLINE RD - APPLICATIONS - 11/18/2005BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-61M
BUILDING .PERWr APPLIIPATION
Last
First
Middle Phone
ar
Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE.
dr
City State Zip CO
Ck
Y/Mrr
,
mpan ame
License Number
Supervisor & Cert. #
Mailing Addr ss
City
State Zip Code
S
hone
Please
Specify: LN. DR. CR.
WY. PL. ST CT RD. AVE. Zip Code
bdivision/PUD
A
CM
0
Filing tuber
BI k
Lot Area
�t
Building Square Footage
Number of Stories
Building Height
Lumber
of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
�,
Stock PlaNumber/Options
Radon
Energy Score/ E-Star/AirSealing/Blower Door
Y N
WaterT p Size
SewerTap Size
Metered
3 x
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
gtas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other.
r?es ❑ No
1 1111119 M1, (including labor material profit)
-00
DeS�iiption pf Work
/ ,,. f .� „Jinn %3o-• "Y] _ 400J/1
Job Contact Name & Phone #:
Subcontrac r Names:
Electrical Mechanical �� i I -Plumbing
—
Framer 7%'Gl Roofing Concrete
CL
a
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements corgiaiRgd herein od city ordinances and state laws regulating building construction.
Signature
Print NamE / 2040 Y41%
White — Office
Phone
Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE