HomeMy WebLinkAbout2156 W Plum St - Applications/Deck - 11/17/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 3 J
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION DATE L J / O
APPLICATION NUMBER
Job Site Address RISC V" R, M Sy Unit #P
7 /
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Q 3 - O 3 63
Last Name s-r" /I/4 First Name J i m Middle
Street Address /a S J. //0we,//sJ-4 city FA. Colhoi- State CQ_Zip905(g]
CONTRACTOR INFO: Company Name J/ M /!'8150>7 Co A S llContractor Phone #_9 70 - a a S - O Y 9,j
Lie. Holder Name J/ on "e lfo h City of Fort Collins License # 49111 Supervisor Cert #
Mailing Address 34 1 a 4R 4Ila m 69 4 Cl City FV Whh f State C 0 Zip YOU 6
LEGAL INFO:
Subdivision/PUD
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq
Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
ls' Floor Sq Ft 2M 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
City of Fort Collins Stock Plan # List appropriate option
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 (in
cluding labor, material & profit) $ '/� 7 90. 00
Description of Work: / C e m o ll G %1l .4 /q G e C k / 5 71, r! VeG lt VT 0j64.r looj,-S
Contact Name & Phone # of JOBSITE SUPERVISOR: V I m Ale, 15-Oh 9 70 - as 7- 000 6-
Subcontractor Info:
Electrical Mechanical
Framer f rh Alelso" COhAoofing
Concrete
Plumbing
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 Collins ordinances and state laws regulating building construction. A,
Applicant Signature 9 /6710 t Print Name G✓t;, /I/&/j-0h Phone L1 y3- 7595-
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE