HomeMy WebLinkAbout3621 Richmond Dr - Applications/Addition or Alteration - 11/27/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
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City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER v �(c 0APPLICATION DATE I! ✓;,L- 7't5 (0
Job Site Address .3(0a 1 K IGNMaNj Zy- Unit #
PROPERTY O-WNN'ER INFO: (All owner information is required - it is not optional) Phone # q71- 4fl"�
Last Name JGNmIAJQ5 First Name a Middle
Street Address 3&A-Q,e,,I/'1'IoJ D✓ City . colhn-s State-11--Zip�
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Ad
Contractor Phone
1
City of Fort Collins License #.
City
LEGAL INFO: LOT 3, 5k4w iQ b►crc-s G 1 .L
Subdivision/PUD _ sk4 l ine- Aar" Filing #
Supervisor Cert #
State
Lot # -3 Block # Lot Sq Ft 1.7.5 AbrBs
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) - Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths 3/< Baths /z Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s k
Metere : Yes r No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker
�Size(Residential only): ,A150/A/mp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & _pronfit))� $ �'"%3Co, "� �J , 7'�`�'
Description of Work: r �Oa a0 K �-(a f�l[ktx�l�huy� py� pvr,t / l�tAyygfaG .
Contact Name & Phone # of JOBSITE SUPERVISOR: cj
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete Other
Applicant: I hereby acknowledge that I have read t_Wapplication and state that the above information is correct and agree to comply with all requirements
contained herein and City of F ollins ordinan � nd state laws regulating building construction.
Applicant Signature - Print Name /4?04 J rt Phone
Distributio White —Office Yellow —Applicant Pink — WWW/Stormwater Cal 4411 A7i0
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE