HomeMy WebLinkAbout4702 SNOW MESA DR - APPLICATIONS - 8/6/2004BUILDING .PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
www.fcgov.com
BUILDING PERMIT APPLICATION
Last
First
MiddleEMEMEMSEEMEEM
Phone
o
Street Address Please
pecify: LN. DR. CR. WY. PL. ST. CT RD. AVE.
City State Zip Code
momrNN 10 Lx
a0
Company Name
P Y
License Number
Supervisor & Cert. #
r
s`
A-- 1
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Mailing Address
City V
State Zip Code
6
Phone
Please Spe ' LN. DR. CR.
WY PL. ST CT. RD. AVE. Zip Code
C-10, 7 0 Z_.
Subdivision/PUD
CM
°;
U v
iling Number
Lot Block I
Lot Area
.
Building Square Footage Number of S ories 2--
w
Building HeightLdt.
(�
LNumber
of Dwelling Units
Number of Bedroom /Bathrooms Unfinished/Finished Basement Sq. R.
C,
Stock Plan Number/Options
Radon
Energy Score/E-Star/Air Sealing/Blower Door
Za—
Y/N
Water TapSize�
Sewer Tap Size
9 Metered
Type of Heath
Electric Main Breaker Size (Residential Only)
Temporary Electric Pedestal Requested:
�'—
s €tM rlc—
❑ 150 amp or less ❑ 200 amp ❑other
❑Yes No
662i
1 1
(including labor, material, profit) $
S [ 3 g40, oo
Description
of Work:
UlJ
X U-_
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contain ordinances and state laws regulating building construction.
C
'a Signatur
CL
Print Name A Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE