HomeMy WebLinkAbout6132 TILDEN ST - APPLICATIONS - 11/19/2003BUILDING PERtvIITS & INSPECTIONS IiTVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
Last First First
Middle
Phone
03
Street Address Please Specify. L . R. CR. WY PL. ST. CT. RD. AVE.
Cityt,
Zip Code
t
nsltate
I
L
ompa i Namerar I l
`
ZntWenseoNunyber�
Id
I
Super isor & Cert. # 4
Mailing Add11re'Sate
I SQh! )IXtJQ Y C� 1/�
�Q 0�0 v
Zip Code
co . 8QS3
P L10 5(?3 �a
1:
Please Specify:
SITE A11• LN. D R. WY PL. ST. CT RD. AVE. Zip Code
tp�3a�l�a-� ��.
io
Subdivision/ UD
rn
Filing Number
Lot
Block
Lot Are
0
Building Square Footage
Number f Stories
tu�ding Height
LNumber
of Dwelling Units
Number o Bedrgorps/Bathrooms
nfinis /Finished Basement Sq. Ft.
C 3
Stock Plan Number/Options II__
— Cs
Flad
Energy Score/ E-Star/AirSealin Blower Do
lip
Y / N
WaterTSralze�)f
Sewer Tap Size
Mete ed
Type of Heat:
Electric Main Breaker Size ( sitlential Only)
Tem
ry Electric Pedestal Requested:
Gas ❑Electric
❑ 150 amp or less Zoo amp ❑other
Yes ❑ No
1 111111111111111111111M
finrludinn lahnr
matarial nrnlitl @
'7 --7i / C7 '1
0"h;
Subcontractor Names: //��
Electrical 1 504) Mechanical _A 1 r Prod Plumbing �' (�� IA4u
Framer oofing Concrete
{ n lIItI FrtitlP. bit�
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 arjd state laws regulating building construction.
a Signature
a I .. ._ I ,,
I Print Name
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE