HomeMy WebLinkAbout105 Yale Ave - Applications/Addition or Alteration - 10/28/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
6al www.fcgov.com/building o"' rl- (I-Q W17
City of Fort Collins BUILDING PERMIT APPLICATION �I�°°
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APPLICATION NUMBER J/�I `'l / APPLICATION DATE L O i} a - d 4
Job Site Address &5 /VA-/t A-1 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) /Phone
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Last Name �,21j &43) First Name �/L iite,-�i-�Yro�/ i�(/ Middle Street Address lt�S A/e 14t�, City f � (l _ State Cy Zip }�'O�S �
CONTRACTOR INFO: Company Name' Contractor Phone #
Lic. Holder Name
t-� 1 / / City of Fort Collins License # Supervisor Cert #
Mailing Address t/ S/,4 / e ,&�� City T. �cl I/ A%S State Zip
LEGAL INFO:
Subdivision/PUD � e l�P �q 'CS Filing #_4,
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq
15t Floor Sq Ft
# of Bedrooms -,Dr—
Air Conditioning: es No
�esCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Stories_
Lot # 9,3 Block # Lot Sq Ft 70
Total Garage Sq Ft -6--
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Bldg Height /a, 5 # Dwelling Units
2^d Floor Sq Ft Unfinished Bsmt Sq Ft -� Finished Bsmt Sq Ft
# of Full Baths -$- 3/4 Baths _�__ 1/2Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheckNZ�esCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: "a or No Temp. Pedestal: Yes or No
Type of Heat: )<Gas ❑ Electric Electric Main Breaker Size (Residential only):A 50 Amp or Less ❑ 200 Amp ❑ Other
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Value of Construction (including labor, material &profit) $
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: cz- g-(D __91S q
Subcontractor Info:
Electrical QR})ice5Mecchha�nical N�t�ryl Ll a Plumbing A-�pa'l,i CAM A/C
Framer ���f>2N �$�t2llC�gOOIng foe,#��seR���oncrete {�' Xk Other �11
�Pv�,�e �)
Applicant: I hereby acknowledge that I have read this application and state that a above information is correct and agree to comply with requirements
contained herein and City of C ns ordin ifi'I;s nd state laws regulating building construction.
Applicant Signature l`' Print Name /7/G�7�tUF. 14Phone 4:2� } - <
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE