HomeMy WebLinkAbout4702 DUSTY SAGE LOOP - APPLICATIONS - 11/7/2003BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
cStreet Address Please Specify: LN. DR. CR. WY. PL. ST. CT RD. AVE. A
Company Name License Number
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Mailing A s
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Please Specify.
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Subdivision/PUD
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Filing Number
Lot ,
Building Square Footage
Number of Dwelling Units C� ,
Block
Number of Stories
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60 <W5.2
& Cert. #
'I CT. RD. AVE. 57
Zip Code
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Building Height I ��
asement sq.
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Stock Plan Number upwn
Water Tap Size a ;, Sewer Tap Size Metered 5
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Type of Heat: Electric Main Breaker Size (Residential Only) Temporary Electric Pedestal Requesift
❑ Gas ❑ Electric ❑ 150 amp or less ❑ 200 amp ❑ other ❑ Yes ❑ No
=jjMM&ZWLjUi (including labor, material, profit) $
Description of Work:
Job Contact Name & Phone #:.9_1 L) -- t ( �
Subcontracter`Names: `f �/► ,, A
Electrical JVrJf� +5 `� Mechanical � �v � G`- 1 %d1umbing
Framer %���� (__ Roofing l�z-��'� �r.� ,.Q1baF �GLics ti�
I hereby acknowledge that I have d this tion d ate that the above information is correct and agree to comply with all
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requirements containV herein city I nce e s regulating building construction.
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C.I.
'o. Signature
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Print Name 'Phone1G'
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater