HomeMy WebLinkAbout6714 AUTUMN RIDGE DR - APPLICATIONS - 8/16/2002City of Fort Collins
BUILDING PERMITS & INSPECPIONs DIVISION
P.O. Box SM • Fort Collins, CO 80522-OSM • Phone: 221-6760 • Fax 2U-6134
BUILDING PERMIT APPLICATION
OEM=
Last First Middle Phone
iv
r1 3 F r Ca m E.
c
Street Address Please Specify: LN. DR. CR. WY. PL. ST. CT. RD. AVE. City State Zip Code
E' �40t E (3F i F e � I f= CS C±
C-E--NUE-rL- CU 623'i
Company Name License Number
SFtrnE
Supervisor & Cert. #
S
b- 3'7 3
GZ - �, 'ZoSo
Mailing Address City State Zip Code
C
fo
Phone
3�3 -zn (oococl
Please Specify: LN. DR. CR. WY. PL. ST. CT. RD. AVE. Zip Code
F
D_ Zr <l E_
Subdivision/PUD
io
Pr2.o v 1 cv LE_TC) c�
a
Filing Number Z Lot t L Block
Lot Area
Building Square Footage Number of Stories
Building Height
1 L-t I S Z
30 •mR u
Number of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
r
ti
3 z
ry ( R
S
Stock Plan Number/O lions Radon
Energy Score/E-Star/AirSealing/Blower Door
Y/
(3 ls3Ct--� E-U-2- b O O vZ
Water Tap Size 3 (� SewerTap Size
Metered
ti
Type
Electric Main Breaker Size (Residential Only)
Temp rary Electric Pedestal Requested:
ic
150 amp or less ❑ 200 amp ❑ other
TYes ❑ No
'(including
labor, material, profit) $
uescnpuon of worK:
W-
P i l= V 3
Job Contact Name & Phone #.
( A-rLTC_! fV
subcontractor Names:
Electrical -S.7 E-k�c-T IAJ C-
Mechanical PoL-)r->-x>_t= L--u/O-LL V Plumbing Pwrn ('3 t -rat C, SOU
Framer 1) (Z > t ry Roofing CA-mpr?,E-L-` P-ep rZfJ Concrete
Ca
Q
o.
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 (zcle- u a VV) C!r-e�_
Print Name C jl�--- f-" rv) Ca t Z
Phone 3 403 ZZLc�, to a cE,
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE