HomeMy WebLinkAbout938 MAPLE ST - APPLICATIONS - 8/19/2003City of Fort Collins
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BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-058o • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
First Middle Phone
S,� l�Please Specify. LN. DR. GR.
-�WY. PL. ST. CT. RD. AVE. City State Zip Code
Company Name
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License Number Supervisor & Cert. #
o
LLr,
Mailing Address
City State Zip Code
43
Phone
-I
-4 a
1 ;
Please Specify. LN. DR. CR. WY. PL. ST. CT. RD. AVE.
� 1 1 • q 3� Zip Code
/
S
Subdivision/PUDCD
Cn
cusp i
\T �OI�
Filing Number
Lot Block Lot Area
�5
o
Building Square ootage
Number of Stories Bui� ing Heigh
�
Number of Owe ling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
Stock Plan Number/Options
Radon EnergyScore/E-Star/AirSealing/Blower Door
"�
Y/N
WaterT iiy
Sewer Tap Size Metered
Type of H at:
ElectricMain Breaker Size (Residporary Electric Pedestal Requested:
V!2;;,!
❑ Gas Electric
150 amp or less ❑ 200 ❑ Yes o
1 1� S 1 1
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Description of Work:
ow UU11a41 iiamC a( riiune v:
Srt1�� �L4 t i ter- — 9�c� SCd„ 2-¢�4
Subcontractor Names:
Electrical '7— -i?— � ; �,1— Mechanical Plumbing �,c Stepp
Framer ��r Y _ Roofing
t.
I hereby
requirem is contained
-a Signature
a
Print Name
Concreted,
sm .•S•1� �.
and state that the above information is correct and agree to comply with all
state laws regulating building construction.
Distribution: White — Office Yellow — Applicant Pink — WWW/Stornnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE