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HomeMy WebLinkAbout4625 REGENCY DR - APPLICATIONS - 7/29/2003 (2)®,. City of Fort Collins BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 BUILDING PERMIT APPLICATION Last First Middle CD Loiu �q KC c Street Address Please Specify: LN. DR.CR. WY. PL. ST CT. RD. AVE. Clt Company Name License Number 4 44-st 14A ` A5 AiRma Jf Z Mailing Address City State Phone `ram- 2210�'J[G., Please Specify: LN. DR. CR. WY PL. ST CT RD. AVE. JOB SITE ADDRESS 4(*7-4 0 0 L (A 0 c.> Phone State Zip Code Supervisor & Cert. # Subdivision/PUD Filing Number Lot Block Lot Area Building Square Footage —7-5-0 5. Zip Code LCO Zip Code v Number of Stories Building Height Number of Bedrooms/Bathrooms Finished Basement Square Footage © —tom :i�fr. Value of Construction (including labor, material, profit) $ 00 Description of Work: �1����9- Cly.lL�rJG �4biTS Subcontractors: Electrical Mechanical dr..�p�,Jtr iL it, Plumbing U/A 01 Roofing NA Concrete Framer o mf—Cs vsn4 EM2 I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirement nt 'ned �erein and city ordinances and state laws regulating building construction. a Signatur o. Print Phone (4-LO%ZZJw, -5 Distribution: Original — L & P ' Yellow — Office THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE