HomeMy WebLinkAbout624 YARROW CIR - APPLICATIONS - 10/14/2003Last
First
Middle Phone
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CD
Address Please pecify: LN. DR. CR. WY PL. ST CT RD. AVE.
State Zip Code
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^City
( 11 iws
Company Ndme
License Number
Supervisor & Cert. #
CD
Mailing Address
City
State Zip Code
C.13
Phone
Please
LN. DR. CR.
WY. PL. ST. CT. RD. AVE. Zip Code
7peefy:
S bi ivision/PUD
5 1W
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Filing Number
a
Lot Block
Lot Area/(�
Building Square Footage
Number of pries
Building Height
0
Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
f/J
C
Stock Plan Number/Options
Radon
Energy Score/E-Star/Air Sealing/Blower Door
Y/N
VJ
Water Tap Size
Sewer Tap Size
Metered
d
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
❑ Yes ❑ No
M*/:I III►E.
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(including labor, material, profit) $ 7dee — Js-oo
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Description of Work:
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7 !1
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Job Contact Name & Phone #:
Subcontractor Names:
Electrical
Framer
R
.Q
Ca
c.
a
Mechanical
Roofing
Plumbing
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.
Signature
Print Name Lf u 'T D N c 'Z'*tk e Phone •St q3 — 90 Qi
Distribution: White — Office ellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE
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