HomeMy WebLinkAbout3708 Eclipse Ln - Applications/Single Family New - 11/22/2006APPLICATION NUM
Job Site Address
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
WWW.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION DATE /I C;O2
PROPERTY OWNER INFO: (All owner information is required - it is not optional)
Unit # Phone#�3)-7%�((o �001(e�
Last Name `/III ��'First Name Middle
Street Address 20 L OU- / iL 2_ City StatrD Zip
CONTRACTOR INFO: Company Name V 4 C)ntractor Phone
Lie. Holder Name City of Fort Collins License # b Supervisor Cert #
Mailing
City
State Zi
LEGAL INFO: ct
Subdivision/PUD l ,/ / rt'I(L 1 i 00� Filing # I Lot # / I Block # Lot Sq Ft�C�C/
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft alq
r
1
Residential Sq Ft Comm'I Sq Ft # of Stories L
Bldg Height 13 # Dwelling Units
1st Floor Sq Ft
# of Bedrooms 6
2nd Floor Sq Ft Unfinished Bsmt Sq Fta 4�— Finished Bsmt Sq Ft
# 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 D
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 S3N— Sewer
Tap Size
Metered: es r No
Temp. Pedestal: Qor No
Type of Heat: �Qas ❑ Electric
Electric Main Breaker Size (Residential only): ❑ 150
Amp or Less CJ/ 0 Amp ❑ Other
Value of Construction (initluding labor,
rppaterial & profit) $
/ // 3a2, ..65
(/
Description
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical L Y�J SW C�(Mechanical Plumbing Yrt
Framer( (1 Ili11L V� Roofing lA'AQ p E �j12Qr Concrete �U rt A..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 ity of Fort Collins ordinances and state laws regulating building construction. Applicant Signature �kW Name 't�Al �VIQ.< <1 W k-i/—PhoP)� '
Distribution: White - Office Yellow - Applicant Pink - W WW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE