HomeMy WebLinkAbout2157 Nancy Gray Ave - Applications/Single Family New - 03/07/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
(m6�� www.fcgov.conVbuilding
CitpofFortCollins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 50 D 10n /> L/ APPLICATION DATE
Job Site Address Vlff 7 A/Dr"-Iia 611?,aui Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # q5/.3 — 'F61
Last Name First Name Middle
Street Address Q Bat-i- ; / City Su//g&C State eld zip 8��
CONTRACTOR INFO: ompany NameZJ&5nZd Contractor Phone # .:::Po.-7- 541- 9151
Lic. Holder NameY;,-r,741 City of Fort Collins License # 55 Supervisor Cert #
Mailing Address,Y/CLja o �� City State Zip
LEGALINFO:
Subdivision/PUD cd1Gf Of Filing # Lot #-7 Block # Lot Sq Ft ,Z,
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft A114
Residential Sq Ft /o�, 95 Comm] Sq Ft 0 # of Stories z Bldg Heightoor�g 16 /1 # Dwelling Units lZ�
1st Floor Sq Ft K,7:F 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft����,,,'/
# of Bedrooms !� # of Full Baths Z '/ Baths 0 % Baths _�_ # of Fireplaces
Air Conditioning: Yes Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Doo 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # / % List appropriate option #s
UTILITIES INFO:
Water Tap Sized Sewer Tap Size Metered<56 No Temp. Pedesta Ye or No
Type of Heat: Ir'Gas ❑ Electric Electric Main Breaker Size (Residential only): IE'150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ /J_�-
Description of Work:
Y70 00-7
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: Electrical AgeAt5wo L'5exVX2. Eke, Mechanical W0?-4rZ0 MAV - Plumbing ( y�
Framer Roofing 774ie,44 /! ft hoe Concrete ther4e2t�" 4v#
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 City of Fort Collins ordinances and state laws regulating building construction
Applicant Signature ` Print Name 2L,911 //��G/ Phone 1343- SY/ -
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE