HomeMy WebLinkAbout638 KIM DR - APPLICATIONS - 11/10/2003L
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Street Address Ple se
Company Name
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Mailing Address
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Phone
JOB SITE ADDRESS
Subdivision/PUD
Filing Number
BUILDING ftwirrS & INspwnUNS DIVISION
P.O. Box S80 • Fort Collins, CO 80522-0580 • Phone: 221-6760
BUILDING PERMIT APPLICATION
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Sp{ecify: LN. DR. CR. WY. PL. ST CT. RD. AVE. City State
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License Number Supervisor & Cert. #
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Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE.
State
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Lot Block Lot Area
uwlomg Square Footage Number of Stories
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Zip Code
C 5�5
Zip Code
Zip Code
Building Height
Number of Bedrooms/Bathrooms Finished Basement Square Footage
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Value of Construction �b
(including labor, material, profit) $ -9; (`'7" 3 ,
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Description of Work:
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Subcontractors:
Electrical Mechanical Plumbing
Roofing Concrete Framer
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 ci ordinances and state laws regulating building construction.
Signature \ /
Print Name Yan Phone 9iQ .2Q p — 0a3(4_
Distribution: Original - L & P Yellow - Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE