HomeMy WebLinkAbout810 E Elizabeth St - Applications/Addition or Alteration - 03/13/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
WWW.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER 6O /�_qly APPLICATION DATE ®, 13
/ ®1
Job Site Address 6 !(N, E-asf Ef,zg 12y4-k 7 -ee_r Unit#
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last Name) First Name �� h \P �'� Middle / 7
Street Address e l o F,R'Sf EJ i aa- LA6 :5 �cd City/ r/�rf ( �i�Yr 5 State�Zip�i � 5
¢.rnr 5e_'51 / /
CONTRACTOR INFO: Company Name Q,/�Q�aS'%r Jnn /Contractor Phone #��i �) '`fi� 2
Lic. Holder Name 1 ,��� Q' keJ City of Fort Collins License # !� % Supervisor Cent #L
Mailing Add ress9b/Sm%Wh-'P/j'bri✓2 1-61 City Fy-i a/ nS State Zip
LEGAL INFO:
Subdivision/PUD 16199 - FTC L3 -\ 1(q A Filing # 1 1)1997 Lot # b/� Block # Lgb Lot Sq Ft �J
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 6Q , I b (�` Total Garage Sq Ft 3
Residential Sq Ft ( 9 6 Comm'I Sq
# of Stories_) Bldg Height I Gi'/ # Dwelling Units
1st Floor Sq Ft 2 1 9(7 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft 31P h
# of Bedrooms 3 # of Full Baths 3/a Baths 1 /2 Baths # of Fireplaces I
Air Conditioning:(a)--No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option #s
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: P(Gas ❑ Electric Electric Main Breaker Size (Residential only): Id150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)) $
Description of Work: (a�
L"
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical 44 k 10 4E- i C , Mechanical ✓Plumbing%%gv?�u'/yk'x
Framer 11502n l'M5,4rItn Y-0J1 Roofing iLJ�/� Concrete 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 City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE