HomeMy WebLinkAbout3633 Rocky Stream Dr - Applications/Single Family New - 10/12/2006APPLICATION N
Job Site Add
BUILDING PERMITS & INSPECTIONS DIVISION jt,
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P.O. Box 580 • Fort Collins, CO 80522,0580 • Phone: 221-6760 61 vt
www.fcgov.com/building 4 l p'5a
BUILDING PERMIT APPLICATION I''Y� qi nv
APPLICATION
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PROPERTY OWNER I / owne ' , - i is not optional) Phone # 9- - �®7- 1 7¢
Last Name �(
Y- 55, First Name Middle
Street Address 24l s. v i. i 2Tfi —^ City k MVe74hN1,D State 4&9, Zip ACOQ57
CONTRACTOR INFO`: Company Name ITL sr y 1 N4I*MGAontractor Phone # G - (d -I- i7�
Lic. Holder Name _)1IIVlCity of Fort Collins License # Supervisor Cart # Zti
Mailing Address -?�- . I-2 4 cam. City AN&!,p State Gp. Zip scxs--,%-T
LEGAL INFO:
Subdivision/PUD jJI��t7S .�G iling # Lot #- 45 Block # Lot Sq Ft_A_
CONSTRUCTION INFO: Total Building Sq Ft (not includiP gnbasement) 75O 9 Total Garage Sq Ft '1
Residential Sq Ft 49-15 Comm'I Sq Ft # of Stories_ Bldg Height # Dwelling Units
1st Floor Sq Ft '3059 2nd Floor Sq Ft N,Ar� Unfinished Bsmt Sq Ft %?-Cf'F-7 Finished Bsmt Sq Ft
# of Bedrooms _ # of Full Baths — -/< Baths 2 /z Baths �— # of Fireplaces 3
Air Conditioning: es No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
Water Tap Size i Sewer Tap Size 4— Metered: e5s> or No Temp. Pedestal: (f5i or No
Type of Heat: XGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less A 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ �{ f % Z�j� , �C✓
Description of Work:_ PJARD F_ SiAI/,/j� 7FUA r
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Contact Name & Phone # of JOBSITE SUPERVISOR: V I- kajj 970 Z 15 IS04/jtw& Lo M y-705gl p61:F,
Subcontractor Info:
Electrical 1JdP1?3r,s, W (a/a}. M Mechanical Etl'65vI.1 'F-�/Acr Plumbing vifty-- Pbumau
Framer KCL 1156LJIRoofing - ' - k • ib"iI Concrete OW45*1 666-16, 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 s rdin and state laws regulating building construction.
Applicant Signature Print Name E�Zl(� ri7. F[e-/A) Phone970-"7- ,/—A/
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE