HomeMy WebLinkAbout5457 Jupiter Dr - Applications/Single Family New - 09/20/2006City of Fort Collins
/�?,, 3 -L?.
BUILDING PERMITS &i INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ..I �C / C�/O - 1 �J APPLICATION DATE
Job Site Ad
I owner information is required - it is not
Street
ame
Lic. Holder Name
Mailing Add
Middle
State Zip
i I yr nI -) Contractor Phone #
City of Fort Collins License # —IN �p H
City
LEGAL INFO: nn n G
Subdivision/PUD �� l A1� Ji 1(i��Ll/ moiling # Lot # 1 `
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft �Z Comm] Sq Ft_
1st Floor Sq Ft2nd Floor Sq Ft
# of Bedrooms # of Full Baths
-yL)I
Supervisor Cert #
State Zip
/�/cl c�
Block # O Lot Sq Ftmaw
Total Garage Sq Ft I�
# of Stories f Bldg Height # Dwelling Units `
Unfinished Bsmt Sq Ft i/ Finished Bsmt Sq Ft r
a '/< Baths A '/z Baths # of Fireplaces
Air Conditioning: es No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door . E-Star w/Blower Do 'r 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size 3� 1 Sewer Tap Size �_ Metered: n or No Temp. Pedestal: es or No
Type of Heat: \qoas ❑ Electric Electric Main Breaker Size (Residential only):19050 Amp or Less
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: -
❑ 200 Amp ❑ Other
t- I . ' 1- f
Electrical tJ Q, � Mechaniic�al �Vr-( ( �WY tt-w( Plumbing ajDr
Framer ��(���[Si� Roofing Wt%concrete�%l11_ L� Other
`i
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all requirement 3
contained herein and City of Fort Collins ordinances and ,state
^laws regulating building
construction. A n
Applicant Signature' `\�l�'t Print Namel`�\�W" Pho�e J ► 1
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE