HomeMy WebLinkAbout2044 Raven View Rd - Applications/Single Family New - 02/26/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
monoof www.fcgov.com/building
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CityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �%' �V / APPLICATION DATE 0- —1�4-0T
Job Site Address /Pj% -el Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name tnl1QC1 rTthL First Name j� Middle
Street Address (33�' 4w1a a, / City r �C rf /1� State Zip
CONTRACTOR INFO: Company Name /IG�K! ►V6'✓� 0 ddiContractor Phone # `79i^Oro� Qom/
Lic. Holder Name eUSW
'K- ne,/IS City of Fort Collins
/License # Supervisor Cert #
Mailing Address City ��' (iLa/l1/� State Zip 60V al
LEGALINFO: �� /
Subdivision/PUD ayem Vf01N Filing # / Lot #_I— Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) I/s6 Total Garage Sq Ft ;Ucp
Residential Sq Ft Comm'I Sq Ft 0 # of Stories 0Z Bldg Height .2S� # Dwelling Units
ls' Floor Sq Ft S" I& 2nd Floor Sq Ft Unfinished Bsmt Sq Ft S*74- Finished Bsmt Sq Ft
# of Bedrooms 02 # of Full Baths 2 3/4 Baths /2 Baths I # of Fireplaces O
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 Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # /?6:7 List appropriate option #s
UTILITIES INFO:
rr rr
Water Tap Size Sewer Tap Size y Metered: Or No Temp. Pedestal: Or No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only): J(150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & prof/it) $ W
Description of Work: /i%ew 5-/h j/� /L'T/leyIGe-
Contact Name & Phone # of JOBSITE SUPERVISOR: bt 5- Y 6 0211 oZa-
Subcontractor Info: r/�/ / /
Electrical) oFvvy l Mechanical I`��,Cz'L , / Plumbing
Framer I1V r I (� Roofing t Co 5' Concrete A e ctj& Other
Applicant: I hereby acknowledge that I have read is application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort Collins or in sand state laws regulating building( construction.
Applicant Signature Print Name 1 \ ►r 0 (S Phone
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE