Loading...
HomeMy WebLinkAbout3627 Big Dipper Dr - Applications/Single Family New - 01/17/2007APPLICATION NUMBER .'. `1 s uv i 1BUILDING PERMITS & INSPECTIONS DIVISION o,MPO B& 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION DATE / Job Site Address, 2 Unit # PROPERTY OWNER INFO: (All forrJlon is required — it is not optional) Phone t3/77to Last Name' ' rst Name Middle aa Street Address City StateZip V�t� ' CONTRACTOR INFO Campan Name Contractor Phone # ,3 Lic. Holder Name / V LA City of Fort Collins License a)qbq Supervisor Cert # 11 �// Mailing Address % �CClra��[l('D City State Zip LEGALINFO: Subdivision/PUID �1[/ �i'� �/� Filing # of #A�_ Block /age Lot Sq�FtOm CONSTRUCTION INFO: Total Building Sq Ft (not including basement) / i✓� Total G�L-- Resid7rSq 'I Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units 1st FlFt D 2cd Floor Sq Ft Unfinished Bsmt Sq Ft ��`iFiiin�ished Bsmt Sq Ft # of Bedroor y� ,C� # of Full Ba '/4 Baths /� # of Fireplaces V Air Conditioning: Yes No Energy_info, cle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door 4. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # iE-Star w/Blower D List appropriate option #s UTILITIES INFO: / J ✓ L Water Tap Size 3 Sewer Tap Size � Metered: es r No Temp. Pedestal: es,Af No Type of Heat: as ❑ Electric Electric Main Breaker Size (Residential only): 150 Amp or Less Value of Construction (including labor material &profit) $ i "71 0, b© Description Contact Name & Phone # of JOBSITE SUPERVISOR: Applicant: I hereby acknc contained herein and City Applicant application and state that the above nd state laws regulating building Bons ❑ 200 Amp ❑ Other is correct and agree to comply with all requirements / 1 , Distribution: White — Office Yellow — Applicant!. 'Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90�DAYS FROM APPLICATION DATE