HomeMy WebLinkAbout614 E VINE DR - APPLICATIONS - 4/25/2003 (2)BUILDING PERMITS & INSPECTIONS DMSION
City of Fort Collins
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
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Middle Phone
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Street Address Please Specify: LN. DR. CR. WY PL. ST CT RD. AVE.
City State Code
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Company Name
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License Number Supervisor & Cert. #
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Mailing Address
City
State Zip Code
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Specify: LN. DR.
CR. WY. PL. ST CT RD. AVE. Zip Code
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Subdivision/PUD
CD
Filing Number
Lot Block
Lot Area
Building Square Footage
Number of Stories
Building Height
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
N
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Stock Plan Number/Options
Radon
Energy Score/E-Star/Air Sealing/Blower Door
Y/N
VJ
Water Tap Size
Sewer Tap Size
Metered
G7
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑
other
❑ Yes ❑ No
1 1 1 (including labor, material, profit) $
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Description
of Work: _
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Job Contact Name & Phone #:
Subcontrac r Names:
Electrical F, S . �cc -rf c Mechanical
Framer
Roofing
Plumbing
Concrete I -/C cowGR ItT/--
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.
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Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE