HomeMy WebLinkAbout931 FOSSIL CREEK PKWY - APPLICATIONS - 3/18/2004BUILDING PERmrrs & INsPECTIONs DIVISION J
P.O. Box SW • Fort Collins, CO 80522-OSM • phone: 221-6760
BUILDING PERMIT APPLICATION
Last
First
Middle
Phone
2 2-S 2-777 g
Zip Code
03
Street Address Please Specify LN.
2 P6ss
DR. CR. WY. PL. ST. CT. RD. AVE.
City State
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G-Cc.1L P 16W
Gt(Iti.s C o
g o s—
Company Name
License Number
Supervisor & Cert. #
0
R Mailing Address City State Zip Code
0
Phone
Please Specify: LN. DR. CR. WY. PL. ST. CT. RD. AVE. Zip Code
JOB SITE ADDRESS
a
of
J
0
Subdivision/PUD
Filing Number Lot Block Lot Area
Building Square Footage Number of Stories Building Height
Number of Bedrooms/Bathrooms Finished Basement Square Footage
I(o(r2
Value of Construction (including labor, material, profit) $ �' R '� . , ,� (4c- O C V
5 1 a( �
Description of Work: t
Subcontractors:
Electrical C7, �,cNa-�,lL Mechanical Plumbing se �-
Roofing Concrete Framer -Ke "t-VeWoUl-
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements Zn5��;
ances and state laws regulating building construction.
w
a Signature
Print Name J :z— Phone Q?0 2Z. S 7-3-V
Distribution: Original — L & P Yellow — Office
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE