HomeMy WebLinkAbout914 S COLLEGE AVE - APPLICATIONS - 2/15/2005City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 • Fax 224-6134
www.fcgov.com
BUILDING PERMIT APPLICATION
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First
Middle Phone
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Street Address Please Specify: L DR. CR. WY. PL. ST. CT RD. AVE.
City State Zip Code
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Company Name
V License Number
Supervisor & Cert. #
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State p Zip Code
Phone
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Please
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Specify: LN.
DR. CR. WY. PL. ST CT RD. AVE. Zip Code
Subdivision/PUD
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Filing Number
Lot Block
Lot Area
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Building Square Footage
Number of Stories
Building Height
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Number of Dwelling Units
Number of Bedrooms/Bathrooms Unfinished/Finished Basement Sq. Ft.
" 1
' • J
C.,
Stock Plan Number/Options
Radon
Energy Score/ E-Star/Air Sealing/Blower Door
Y/N
Water Tap Size
Sewer Tap Size Metered
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Type of Heat:
Electric Main Breaker Size (Residential Only)
1-0
Temporary Electric Pedestal Requested:
❑ Gas ❑ Electric
150 amp or less 11200 amp
❑ other
❑ Yes ❑ No
r (including labor, material, profit)
$ p O
D ription of Work:
Subcontractor Names-
Electrical..L, Mechanical Plumbing y7/1�—
Framer LQg(1 c fZc.t. Roofing A ,T%y Concrete (). L , Ala
I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all
requirements contained herein nd ordi ce nd state laws regulating building construction.
'a Signature
Print Name Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE