HomeMy WebLinkAbout828 PETERSON ST - APPLICATIONS - 8/12/2003 (2)BUILDING PERmas & INSPECTIONS IUIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
Last
First Middle
Phone
c
Street Address Please
Specify: LN. DR.
CR. WY. PL. ST. CT. RD. AVE. City
State Zip Code
Company Nqne
License Number
Supervisor & Cert. #
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i
Mailing Address
City State
Zip Code
L
C
O
Phone
Please Specify:
LN. DR R. WY. PL. ST. CT. RD. AVE.
Zip Code
JOB SITE ADDRESS
y
-
Subdivision/PUD
Tv
CM
Filing Number
Lot
Block Lot Area
Building Square Footage
Number of Stories
Building Height
0
Number of Bedrooms/Bathrooms
Finished Basement Square Footage
0
w
Value of Construction (including labor, material, profit) $
AU �;AS LdAJ2 Fx&" 1"�z 7-6 4,1-,�6',
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Electr6alr Mechanical Plumbing�y �w1Je�
SYRofing Concrete Framer T14 6G L4
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
CL
Signature
CL
Print Name Y (,-ZZAti/ - �"T/� iQx�j� Phone
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE