HomeMy WebLinkAbout5224 Mcmurry Ave - Applications/Deck - 11/06/2006BUILDING 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 r /V �y t�`/ APPLICATION DATE 1 I (1(J — V x "
Job Site Address J7_ �?([tI�„�Yf�'� Unit#
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ZZ3 i0y7
Last Name ��Z=Lz Z First Namew (r Middle
Street Address �`ZZy /✓I vylV/�/L�l Qe City/ r,�,� 1 S State 49 zip '0 3SZ,S
CONTRACTOR INFO: Company Name kLx l I ^J& ColySi - kJ L Contractor Phone # Z Z 7 y 7 / %
Lic. Holder Name_S l= ��;Jw6- City of Fort Collins License Supervisor Cent # Z Z
Mailing Addressffb 3 LOnI r.TL�• City �� t�LL t „.s f State Ly Zip ofot T Z {e 1
LEGAL INFO:
Subdivision/PUD LSi DihC 47 I/�gFiling # i2 Lot #— Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1 q L Total Garage Sq Ft
Residential Sq Ft
181 Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Comm'I Sq Ft.
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft (�
# of Full Baths % Baths
Energy info: (Circie appropriate choice)
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
5. Prescriptive w/Air Sealing
List appropriate option
Metered: Yes or No
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
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) $ 1 L9 1 . D D
Description of Work: 60 t=XI.STI.Jt',- 4 //) OAJ 7qZ eej ✓; � elf"
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical M , 9+,j q=4j,,)5 L-ZL� Mechanical �I'd Plumbing zl1r4 Framer SOLE Roofing., . K7L?-•J AQdr,,l Concrete Other OJ14
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 Collin ordinances and state laws regulating building construction.
Applicant Signature Print NamPhone7 '/a%%6
Df t�rution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE