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HomeMy WebLinkAbout909 CENTRE AVE - APPLICATIONS - 5/19/2004 (8)BumDING PERMITS & INSPECTIONS DmsION AKIN P.O. Box 580 • Fort Collins, CO 805224580 • Phones 221-6760 • Fax 224-6134 Cityot Fort Collins BUILDING PERMIT APPLICATION Application Number��n ilk I ast First Middle Phone rJ"t9W4i;MT- 1 9b - 2 f o StreetAddressPlease Specify: LN. DR. CR. PL. ST CT. RD. AVE. City State Zip Code � 44 1�,-L 4i- &57 -Company Name License Number Supervisor & Cert. # 0 Mailing Address City State Zip Code c00 8-ox Z422/0 Phone , E.r Please Specify: LN. DR, CR. WY. PL. ST CT RD. AVE. Zip Code q09 Cei1��� Ve eAF Gay-G SubdivisionlPU© T aF T�K- 354 D 'r o CO ge - ► ice' .+� 1 A, C e-(�-%s ENL a; Filing Nu ber Lot Blo Lot Area Buiidin Square Footage Number of Building Height )jtories f /f Number of Dwelling Units Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft. cc Stock Plan N mber/Options Radon Energy Score/E-Star/Air Sealing/Blower Door Y/N Tap Size Sewer Tap Metered CaWater /Size Type of Heat: Electric Main Breaker Size (Residents I Only) Tempo ary Electric Pedestal Requested: 0 Gas 0 Electric ❑ 150 amp or less ❑ 200 amp ❑ other Yes 0 No Description of (including labor, material, profit) $ 2/Q M 0 4 I hereby ackno edge that I have read this application pnd state that the above information is correct and agree to comply with all requirement dained herein d cr ' races a state laws regulating building construction. cSignature a a !1 Print Name Phone -j W Distribution: White — Office Yellow - Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE