HomeMy WebLinkAbout2414 Ballard Ln - Applications/Single Family New - 05/07/2009APPLICATION NUM
Job Site Address
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO W52USM • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
O APPLICATION
Unit #
PROPERTY OYVNEJRJNM: (All owner information is required - it is not optional) Phone # 270 A' `JQ %W
Last Nam First Name Middle
Street Address 7��'i/ State CO zip 80G1
CONTRACTOR INFO: Company Name ` Contractor Phone
Lic. Holder NameZ_ ` -1��-- City of Fort Collins License # Z5-�5 Supervisor Cart #
Mailing Address '745/ W,40
' Sf �� L ,ZdO City state_CO z;p �j ryl
t t� stet tNFn•
Subdivision/PUD ma he- /"7/ I Filin11-4
g #�_ of # Block # Lot Sq Ft
CONSTRUCTION INFO• Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Comm'I Sq Ft # of Stories BldgHei I
gl�d# Dwelling Units
Ist Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt S Ft _
q Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths _ % Baths 'Y2 Baths l # of Fireplaces �
Air Conditioning: kYes- No Energy Info: (Circle appropriate choice) I. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. -Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan N List appropriate option #s
UTILITIES IINFQ*
Water Tap Size Y Sewer TapSize r
-/ Metered Yes r No - Temp. Pedestal:oYesor No
Type of Heat: IV/Gas O Electric Electric Main Breaker Size Residenttiiaal only): II?/1 50-A p or Les 200 Amp ❑ Other
Value of Construction (including labor, material S profit) S� r Y "� In 1 -, C ✓l n 1 nrt/✓F 1.
Description of Work:
Contact Name 8 Phone # of JOBSITE SUPERVISOR: �(� j� -�i(� (� 97D
Subcontractor Info,• L
Electrical L eC lI"/ L Mechanical %i') i/ A// Plumbing
Framer `\` oofing Concrete
in 2/dCt_Other
Applicant: I hereb acknowledge that I have read this application and state that t e above information is correct and agree to comply with all requirements
contained herein and Ci f Fort Collins inance nd state laws regulating building construction.
Applicant Signature Print Name ! ~ c 1
.�---�, Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE