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HomeMy WebLinkAbout4700 CHIPPENDALE DR - APPLICATIONS - 1/4/2005,. BUILDING PERMITS & 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 Appilication ©ate l .10, �(4 Last First Middle Phone c Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. City 4 c ��� ,ram 6)W1q5 State c0 Zip Code 805Z6 Company Name License Number Supervisor & Cert. # Mailing Address City State Zip Code 0 Phone Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. Zip Code JOB SITE ADDRESS Subdivision/PUD 4(9 AdU� -rlfL' La I3C- - Filing Number Lot Block Lot Area Building Square Footage Number of Stories Building Height 3 Number of Bedrooms/Bathrooms Finished Basement Square Footage Value of Construction (including labor, material, profit) $ J 617, 00 Description of Work: 1 ` / n% ��1ti1 SQ, C-7- L Subcontractors: Electrical Mechanical Plumbing Roofing Concrete Framer R .n CA o. 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 con)aiped herein andSV ordinances and state laws regulating building construction. Signature Print Name SrrCVt"N A. l\ tlo- f"5(..(_ Phone 1 Z.6--©5�3 Distribution: Original — L & P Yellow — Office THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE