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HomeMy WebLinkAbout6939 ROSEMONT CT - APPLICATIONS - 12/3/2003City of Fort Collins BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134 BUILDING PERMIT APPLICATION Last First Middle Phone ( c--(3 G- o rnn E- iv cStreet Address Please Specify: LN. DR. CR. WY PL. ST. CT RD. AVE. City State Zip Code air L-rErs�� t� L Cc�,ot 11 Company Name License Number Supervisor & Cert. # a Mailing Address City State Zip Code cc C � Phone Please Specify: LN. DR. CR. WY. PL. ST. CT. RD. AVE. Zip Code 1 : 1 1 ' (o q 3 CI f LO S Subdivision/PUD r � o+ Filing Number Z Lot zZ— Block Lot Area 51� Building Square Footage Number of Stories 1 ding Height o l y o CP Number of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/finis d sement Sq. Ft. y 1 z1Z 3 x Stock Plan Number/Options Radon Energy Score/E-Star/Air Sealing/Blower Door col 3 1 Y/ L_O' - % e- CO0 0 Y L N Water Tap Size 3 L4 Sewer Tap Size Metered 6i 4 Type of Heat: EI ctrnc Main Breaker Size (Residential Only) Temporary Electric Pedestal Requested: Gas ❑Electric 150 amp or less ❑ 200 amp ❑other Yes ❑ No 1 1 1 ► finr•.ludinn lahnr_ material_ nrnfitl $ ► 1 -7 3 4-, ( . on Description of Work: 3 -3 t C) q � A Z (- (-. C-,, (7- Job Contact Name & Phone #: P ct 1 o s co z S t '? s Subcontractor Names: Electrical E S F Lf (--r Mechanical f ' Y-- f'no Jc'T S Plumbing C- Framer Cs:E. r\s (-�— E a a Q Roofing m'- 7 «�� c_ r- (- 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 "NJ Print Name (-- (-XA Y,�" 0- f-- t.-L--f- -P- Phone 3u ---2> 3 2- 3 ) 133 Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE