HomeMy WebLinkAbout2809 Mercy Ct - Applications/Addition or Alteration - 12/31/2008BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address Z. 80 Alm Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name k:L kl Oy First Name I%s'4a a 4 hd , i /''' Middle
Street Address 'ZSl 14f Lnof Cit`y /�v� trol��hS State C® Zip ?C>576
CONTRACTOR INFO: Company Name"�fAg Cnms1r. (,`'CL. Contractor Phone # 5,67 —/ 5ZZ
Lic. Holder Name fGY�+ l'u`�yie City of Fort Collins License # p-�5 Supervisor Cert #
Mailing Address F'olox 1-2 t City %0'f- 64911-f State 4D Zip .205h
LEGAL INFO:
Subdivision/PUD Uul' bteMew P,U• f - Filing # SLot #�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) lq 2
Block # Lot Sq Ft.
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: <eq) No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths X2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size(Residentialonly): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ %c(l S / Z /�
Description of Work: JEX je-n 4 k I`>�t'h e AC b�ks Id V or,?01-- 1 o4-pQ
Contact Name & Phone # of JOBSITE SUPERVISOR: i6eh 5 C % )'S'Z Z
Subcontractor Info:
Electrical P14/1-1 S Mechanical �lJY�_ 14QVI ��i4C Plumbing 9 e4l CAM4-e-JL
,•
Framer P44hC4 (o-tri 414'i Roofing — Concrete B mrwJJ 4 (pride -Other
Applicant: 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 and City of �Fjo�rt Collins ordinances and state laws regulating building construction. // ) `7
Applicant Signature ke �(h N"ve- Print Name keWleYh 1D�YVe. Phone 567`'157 `Z
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE