HomeMy WebLinkAbout909 CENTRE AVE - APPLICATIONS - 5/19/2004 (5)BUILDING PERMITS & INsPECTiONs DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
BUILDING PERMIT APPLICATION
L st
First
Middle Phone
-
- !—!-ex Vices
%isL. 9 2.
CDStreet
Address Please Specify: LN. DR. CR. WY PL. ST. CT. RD. AVE.
City State Zip Code
Company Name
License Number
Supervisor & Cert. #
o`
L
Mailing Address
City
stale Zip Code
o. Z
22(0O
2
6
Phone
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Please Specify: LN. DR. CR.
WY PL. RD. AV l - ` Zip Code
V
G,Li&A
Subdivision/PUD p2T
of -0Z 64X 4D
pit- cF
Cn
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CD
Filing Number
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Lot p to k
-mil'. l;�u t,u ur,► -sae
Lot Area
- Cp
Building Square Footage
Numbe of Stories
Building Height
27 ' -t-o e i,F
Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
Stock Plan Number/Options
Radon
Energy Score/ E-Star/Air Sealing/Blower Door
Y/N
Water Tap Size
Sewer Tap Size
Metered
07
R
=
Type of Heat:
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
❑ 150 amp or less ❑ 200 amp ❑ other
J(Yes ❑ No
1 1 11,1111
(including labor, material, profit) $ 210 18
Description of Work:
C-� `J' >- ASS I
Job Contact Name & Phone #:
t'►'1 9 20 4 - o I o0
Subcontractor Names:
Electrical Mechanical /,( �,l.( Plumbing 14-Lt9i FL-,)P,,y3, G
Framer M/.ti Roofing 1A Concrete ]b-Onm %mac_
I hereby ackr
requirements
R
a Signature _
a
I Print Name
that I have read this applic ion and state that the above information is correct and agree to comply with all
J Per n�t"�tn0,�y�dinan , and state laws regulating building construction.
LA 9-, ALQjfm�t P4e 0) � Z04
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE