HomeMy WebLinkAbout969 NIGHTINGALE DR - APPLICATIONS - 12/24/20034
City of Fort Collins
Last t_ cLJ I e- l.' 1
i W5 z LLC- First
Middle
CDStreet
Address Please
Specify: LN. DR. CR. WY. PL. ST CT RD. AVE.
City
Company Name
License Number
o
Mailing Address
City
State
-P n
Si
Phone
a
Please ecify: LN. DR.
CR. WY. PL.
Subdivision/PUD
CM
<
Filing Number
Building Square Footage
i2
Number of Dwelling Unit
N
1
Stock Plan umber/Optio
Water Ta Sizg
d
1
Type of Heat:
Gas ❑ Electric
1 1► 1
Description of Work'
Number of f tories
Number of Bedrooms/Bathrooms
Y CN 1
Sewer Tap Size
lectr c Main Breaker Size (Residential Only)
50 amp or less ❑ 200 amp ❑ other
(including labor, material, profit) $ t.
970 472 - 23 4
State Zip Code
CT&5-27 V
Supervisor & Cert. #
WE. Zip Code
K --109 Llo-f ( PM
Building Height
Iq 1
Unfinished/Finished Ba ement Sq. Ft.
iergyScore/ E-Star/ irSealin Iowerpoor
Metered
u es
Electric Pedesta equested:
❑ No
i nn Q r R I o 0rti-t6 ' hyt 5 g"i 4-n s► n Q 1
Job Contact Name & Phone #:
Subcontract Names:
Electrical Pyre ru hie c Mechanical Qlr (�p,�r-}�- Plumbing Allen �t
Framer CU.S�r�m Dn- ►fie Roofing Adv nc-xe 7 Rbopa Concrete S n tfh
T— �.--I' t���t�n c � he
II 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.
s I Signature
a
Print Name `� J, \\ i q s Phone CC.
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE