HomeMy WebLinkAbout2155 Orchard Pl - Applications/Deck - 11/17/2006BUILDING PERMITS & INSPECTIONS DIVISION r, i
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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www.fcgov.com/building
Ci of Fort Collins BUILDING PERMIT APPLICATION l
APPLICATION NUMBER MOD �3 " APPLICATION DATE �A ' � I luc `
Job Site Address S Orc A ar Pla c e Unit L-
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 77sj_;;D _a_lb J
Last Name—,! 5—'m— / -/A ' / First Name Ji mr^ Middle
�/ Street Address / Q S S. 0-we'r 5,4 City F4 Co//r hS A State CO zip Rosa/
CONTRACTOR INFO: Company Name Jim MCIS00) Co►y S7� Contractor Phone # 9 70-a aS - OL95
Lic. Holder Name U i ►►'1 ^Ale ho P) City of Fort C
//��•• ollins License # 13111 Supervisor Cert #
Mailing Address 3QI Q AM 6 a (9 4 CT1City f "r• Co 1%i AS State CO zip 8 0 5 a 6*
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Total Garage Sq Ft
Residential Sq Ft
Comm'I Sq Ft
# of Stories Bldg Height
# Dwelling Units _
1st Floor Sq Ft
2nd Floor Sq Ft
Unfinished Bsmt Sq Ft
Finished Bsmt Sq Ft
# of Bedrooms
# of Full Baths
3/4 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
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
Value of Construction (including labor, material & profit) $ 7 , % 90. 0 0
Description of Work: RI e- m o ;ee VL /kA l4 c e Gk r S 71/ 'I ci Deck-, J-01' iSO P08 /S
i_ /_ _ i _ _ . / At- c-. J ...
Contact Name & Phone # of JOBSITE SUPERVISOR: l'/M Ne'40m 9 70 - as 7 - 0 0 0E-
Subcontractor Info:
Electrical � Mechanical AN114
Framer Tirti Ale Iroo Cgnrf Roofing &Z /T Concrete
Plumbing N/%��
Ni
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 Collinsordinancesand state laws regulating building construction. �/
Applicant Signature (t/� '�( Print Name �✓mil 1�B�s0r7 Phone 970 - yy3 - 7595
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE