HomeMy WebLinkAbout468 PEYTON DR - APPLICATIONS - 5/11/2004BUILDING PERMITS Bib INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: =1-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
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Last
First
Middle Phone
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Street Address ase Specify: LN. DR. CR. WY. PL. ST CT RD. AVE.
City State Zip Code
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Company Name
License Number
Supervisor & Cert. #
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Mailing Address
City
State Zip Code
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Phone
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Specify: LN. DR. CR.
WY PL. ST CT RD. AVE. Zip Code
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Subdivision/PUD
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Filing Number
Lot Block
Lot Area
Building Square Footage
Number of Stories
Buildin Height
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
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Stock Plan Number/Options
Radon
Energy Score/E -Star/AirSealing/Blower Door
Water Tap ize
Sewer Tap Size
Metered
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Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
Gas ❑ Electric
'bil50 amp or less 11200 amp ❑ other
Yes ❑ No
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Description of Work:
Job Contact Name & Phone #:
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Subcontractor Names:
Electrical teC�r,c� Mechanical Plumbing t�; ��lv� �At rf f\a
Framer Y-\ j L Sgj2 n,n� Roofing 1aocl a 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 andaity ordinances and state laws regulating building construction.
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a Signature
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Print Name Phone —/P;?/
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE