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HomeMy WebLinkAbout909 CENTRE AVE - APPLICATIONS - 5/19/2004 (3)BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 2M-6134 BUILDING PERMIT APPLICATION Las First Middle Phone 1 6_&Z, 9 70.48Z �9mc CDj Strreeet Address Please Specify: LN. DR. CR. WY. PL. ST CT RD. AVE. CIyState Zip Code `1 ©t21696TW a. _ 6U.11AIS Z 865 ompany Name License Number Supervisor & Cert. # o — 91 L alling AddressCity TTT State Zip Code C 6 Phone «'�o) 004. 0/00 Please Specify: LN DR. CR. WY L. ST. C�D. E. Zip Code 20 g? r ) Subdivision/PUD oF- T��L Ss1) ZT�y4 ,r��taaca-+� o, t�A2r a F i1P.4c-u A 2� co ; t� # G C ttiti 72 - Alm Yet[ r Filing tjNuum_ ber Lot ock Lot Area -fT.,.�� - Building Square Footage Nu ber of Stories Building Height LNumber of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft. AAA /4 1A N A Stock Plan Number/Options Radon Energy Score/E-Star/Air Sealing/Blower Door Y/N y Water Tap Size Sewer Tap Size Metered °r N A Type of Heat: Electric Main Breaker Size (Residential Only) Temporary Electric Pedestal Requested: ❑ Gas ❑ Electric 11150 amp or less ❑ 200 amp ❑ other FfYes ❑ No 11 118i1]BiKI1(including labor, material, profit) $ ( , CM CMA�abA;7 , )5, o Description of Work: �CAP- /� V�tD4i7oA Onll.W "f—tJ2 A e� S 1A-,-L 4ZV2A,(,, 6�7 Ap�(=,E it�B a" F,.-,-- 4, i-Z7 W*-- i ,Q C,_ 1 Job Contact Name & Phone #: -boo(, yVl4.4i� 970.2o4-_oioy Subcontract% Names - Electrical ,�c/ Mechanical Plumbing A,_- _u LM4 RIJ(., Framer N, /A Roofing At 1A Concrete 1Aft z)- q I hereby ackn �vledge that I have read this applic I n and state that the above information is correct and agree to comply with all requirements c ntaine 'her I an dinanc and state laws regulating building construction. c .Ca Signature a 1n Print Name Phone off V �cXJ Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE