HomeMy WebLinkAbout2401 S COLLEGE AVE - APPLICATIONS - 4/30/2004n iunc
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cStreet Address Please Specify. LN. DR. CR. WY. PL. ST. CT RD. AVE. City State Zip Code
Compan6 Name License Num er Supervisor & Cert.
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A Mailing Address - City State Zip Code
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w Phone
Please Specify- LN. DR. CR. WY. PL. ST CT RD. AVE. Zip Code
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Fill u ber Lot Block Lot Area
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Build ng 9quare Footage Number of Stories Building Height !�
Number of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/Fin ished Basement Sq. Ft.
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CID, Stock Plan Number/Options Radon Energy Score/E-Star/Air Sealing/Blower Door
Y/N
co Water T Side Sewer Tap Size Metered
Ty of Heat: Electric Main Breaker Size (Residential ON TemporaryElectric Pedestal Requested: t9
as O Electric ❑ 150 amp or less ❑ 200 amp other ❑ Yes ❑ No h
1 r t (including labor, material, profit)
Descrip��ppn of Work:
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job contact Name & Phone #:
Subcontractor Names:
Electrical Mechanical Plumbing
Framer Roofing 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 con fined herein and city ordinances and state laws regulating building construction. 3b3_Zr,Z 377�
a Signature L S
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Print Name Rhone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE