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HomeMy WebLinkAbout1320 NASSAU WAY - APPLICATIONS - 8/5/2002City of Fort Collins BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134 BUILDING PERMIT APPLICATION Last First Middle Phone o 1GYt l n c Street Address Please Specify: LN. DR. CR. WY. PL. SSTT CCT/1RD. AVE. City State I NA yZip Code j Company Name License Number , pervisor & Cert. # _`~ ` I��I�V� ` L Malin Address g City Y State Zip Code Phone It Please Specify: LN. 13x DR. CR. WY. PL. ST CT RD. AVE. Zip Code division/PUD w o+ oytul Ali Number Aqt BI k �—Llot Area Y -ri '� o� o� Buil g are Footage Number of Stories Buildin Height f LNumber f Dwelling Units Numteryo Bedrooms/Bathrooms nfinis a Finished Basement Sq. Ft. StockP nNumber/Options RapaEnergy Score/E-Star AirSealin Blower Door YN. H Water Tap Size 3 Sewer Tap Size Metered 2D w, Tye of Heat: -Gas Vc Main Breaker Size (Residential Only) Te porary Electric Pedestal Requested: ❑ Electric 50 amp or less ❑ 200 amp ❑ other Yes ❑ No ' I I W (including labor, material, profit) $ b-1"). -1 Description of Work:It, t 1' I, < Ak Job Contact Name & Phone #: Subcontractor Names: Electrical Mechanical lie, n �4" Plumbing i r Framer r-Fj:—k 1 i dI� Roofing "o&( � I - 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 and city ordinances and state laws regulating building construction. R a Signature Q Print Name L-Vm C mc- h,p Awv Phone l?i0 Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE