HomeMy WebLinkAbout3121 Moore Ln - Applications/Shed - 09/06/2006BUILDING 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 l(J 1 �() APPLICATION DATE 1 —�Y C
Job Site Address I,l2 / Hoare, Unit # }� p p
PROPERTY OWNER INFO: (All owner information is required - it is not optional)
. Phone # g-7(/-�p 9^ U
Last Name Pi✓/A/�ir First Name /��/GA1" Middle
Street Address cowl ✓'IOBr-e— City nf//Cs State_f�9_ZipffA5:;?I=
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO: (�
Subdivision/PUD ��47 -t- G1' eS Filing # Lot #?,3 Block # Lot Sq Ft s"gr
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 37730 Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units m
1st Floor Sq Ft 2^d Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths /2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door N
City of Fort Collins Stock Plan # List appropriate option #s ",
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
C
Value of Construction (including labor, material &profit) $ � T7
Description of Work: / x .50 iB / rq
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical IV ,( tl- Mechanical o!/ %-r� Plumbing V�
Framer P ?"I / yler Concrete 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 Fort C Ilms ordinanc ands ate laws regulating building construction.
Applicant Signature Print Name Y1 drQ, ;271�vu Phone 01 V- Q (/b O
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE