HomeMy WebLinkAbout416 S LOOMIS ST - APPLICATIONS - 9/8/2004BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcsov.com
Citvof Fort Collins BUILDING PERMIT APPLICATION
A
Application Number DU 7c
Application
9-
Last
First
Middle
Phone
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Str/eet Address Please Specify. LN. DR.
CR. WY. PL. ST. CT RD. AVE. City
State
Zip Code
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Company Name
License Number
Supervisor & Cert. #
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Mailing Address
City
State
Zip Code
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Phone
Please Specify:
LN. DR.
CR. WY. PL. ST CT RD. AVE.
Zip Code
JOB
SITE ADDRESS
Subdivision/PUD
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CM
Filing Number Lot
Block Lot Area
Building Square Footage
Number of Stories
Building Height
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Number of Bedrooms/Bathrooms
Finished Basement Square Footage
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Value of Construction (including labor, material, profit) $ V �
Description of Work:
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Subcontractors:
Electrical Mechanical Adf Plumbing 4
Roofing N�i4 Concrete /y �/•t' Framer
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I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requiremenZ_contained herein and city nces and0a#VawVegulating building construction.
Signature
Print Name ,
Distribution: Original - L & P Yellow - Office
Phone ! ' 5!4? :16 "� 7- 7 Z—
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE