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HomeMy WebLinkAbout909 CENTRE AVE - APPLICATIONS - 5/19/2004 (6)BunDnvc Putmns & NSP113 noNs DrvmsioN P.O. Boat SW • Fort Collins, CO N0522.0580 • Phone: 221-6460 • Fax 224-6134 City of Fort Collins BUILDINGPERMIT APPLICATION Application Number La First Middle IC C��r� one c Street Address Please Specify. LN. DR. CR. WY. PL. ST. CT RD. AVE. City State Zip Code O I 4�O' Rn Company Name License Number Supervisor & Cert. # R Mailing Address City State Zip Code c42 2a? � Phone ._ ZU , O / OO Pfea Specify: LN. DR. WY. PL. ST CT RD. AVE. Zip Code Subdivision/PUD Azr or TrAej 49irr-e- i-be 77SZ-. Pdb LiJ&, 1-7 r4 �o A L Ta.N ffo / jt- a _; Filing Number /! Lot /I Block of Area ~- ( ! LLI •► j lAv�.l - W1c Building Square Footage ifiumber of 5tories If Building Height 1 SF' �' 7ia atoi Number of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/Finished Basement A, c�o Stock Plan Number/Options Radon Energy Score/ E-Star/ it Sealing/Blow Y/N w Water Tap Size Sewer Tap Size Metered !, Type of Heat: Electric Main Breaker Size (Residential Only) Temporary Electric Pedestal Requested: 0 Gas © Electric ❑ 150 amp or less ❑ 200 amp ❑ other Yes ❑ No (including labor, material, profit) $1:t-S ©oU Description of Work: Description .e5 1 .jd 1� 4 _ ` A t CAS_ � i�4L.L Job Contact Name & Phone #: uk fil `rAprr ,/ (970) 204. 0 /00 U Subcontrae# r Names: I Electrical t.rvL. Mechanical �J/A Plumbing ,%. � Jm6i►.14� Framer hi A Roofing N A Concrete a- AMP Fault Current ! k=5�► Ngna#ian &�ttirp I hereby ackno edge that I have read this applic ion and state that the above information is correct and agree to comply with all ,., requirements ontaine here' nd c` or inane and state laws regulating building construction. R '4 Signature a `/fit Phone C ""/ S t Print Name Distribution: White —'Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE