HomeMy WebLinkAbout2514 Thoreau Dr - Applications/Single Family New - 03/21/2007City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building \1
BUILDING PERMIT APPLICATION
APPLICATION NUMBER /3�/ 7 _ � d _ APPLICATION DATE 3-c�I Ci 7
Job Site Address ,>' /4 k-j L 0 . Unit # —
PROPERTY
/OWNER
I INFO: (All owner information5
�is required - it is not optional) Phone 4 97d) S,a-7�i�d1
Last Name 0467)1n.4 First Name Middle
Street Address L). a)—pty jd�^ 9 P/-_ y !I City �� / State(- Zip
CONTRACTOR INFO: Company Name Q /Orw .� /l,(w-n a..,0n.contractor Phone # l0 %U)_-3 Q S41M
Lic. Holder Name (i City of Fort Collins License # O S%IE� Supervisor Cert #=2j6n / (i
Mailing Address -�)/7 Sl c9n,fTY� City x, State O Zip ?0(03
LEGALINFO:
Subdivision/PUD v! ' l(I 40' i `blijC Filing # // // Lot #� Block #�_ Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 140F Total Garage Sq Ft 6=u
Residential Sq Ft /4.) ? Comm'I Sq Ft '-" # of Stories -� Bldg Height_-�?,7 # Dwelling Units (
1st Floor Sq Ft iygy 2nd Floor Sq Ft 737 Unfinished Bsmt Sq Ft (n4/ Finished Bsmt Sq Ft
# of Bedrooms .3 # of Full Baths a 3/< Baths 1/2Baths / # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4 t-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # / 757 List appropriate option #s
UTILITIES INFO:
Water Tap Size �_ Sewer Tap Size q ° Metered: es or No Temp. Pedestal: es r No
Type of Heat: VGas ❑ Electric Electric Main Breaker Size (Residential only): ,-150 Amp or Less 11200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ %3�%a./.5 f,%_�alaLkC1i_�l/m�Q�YLu�r?ir� QL�
Description of Work: I /'&I.) h a , A-h-1 dtor 1-14,
Contact Name & Phone # of JOBSITE SUPERVISOR: ajy a--10-cadO) P1Q)539-,2f0
Subcontractor Info: y
Electrical_�'GCl-fLI, ,�t_C / c MIn
�� LyQQ:Zfil,� Plumbing �l'S
Framer ii'� Roofing (-11�I�AdoyA„(oJ�> .�,a Concrete &i-rz re 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 f Fort Collins ordinances and state laws regulating building construction.
1. ''II f�
Applicant Signature d Q PbL Print Name ��rr )�UII��Q/_� Phone 35)-7C'7.2
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE