HomeMy WebLinkAbout220 Peterson St - Applications/Deck - 04/12/2007BUILDING PERMITS & INSPECTIONS DIVISION
r' P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building T I
CityofFort Collins BUILDING PERMIT APPLICATION17,
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APPLICATION NUMBER .6U L o a t cb APPLICATION DATE )MAD
—Job Site Address ,a?�DO Pe�erso^ S +r eP_ Unit# _
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # <i O - a 3 6 o 3
Last Name M 00 I• c. First Name i! cL r r Middle a 6 e r }
Street Address 4)n C> .\CA e e Co Ur f City lre r �- C z-3 1i: s State CJ Zip 1', oSas
-7 CONTRACTOR INFO: Company Name Contractor Phone #
'Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGALINFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft_
Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
Total Garage Sq Ft
'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths 3/4 Baths / Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2- esCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6.
Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: es Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ Other
Value of Construction (including labor, material & profit) $
� Description
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Contact Name & Phone # of JOBSITE SUPERVISOR:
?Subcontractor Info:
Electrical Mechanical
Plumbing
Framer Roofing Concrete Other) 4y 1 i
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.
3 ,@ticant Signatur,,�w �i� Print Name Phone
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Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE