HomeMy WebLinkAbout3721 Green Spring Dr - Applications/Single Family New - 03/22/2007Aur-
City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER &qo [T q APPLICATION DATE 3 -� � 011
Job Site Address 311Z0 CkIeN 560 1116 ;*1 Unit #
Phone # 910 - 6y — d"o
PROPERTY OWNER (INFO: (All owner information is required - it is not optional)
Last Name WL4M76 C! S of J j6rT First Name
Middle
Street Address /U'/ A/. A34 :5 Si4r7t : City lit))kj,0Ss4- State CC . Zip 9OS-S7-d
CONTRACTOR INFO: �Company Name Lc)^jd CV51?J4 /� Contractor Phone # 9'%O —6 %q OZ6
Lic. Holder Name -TOiy 1 c �o� City of Fort Collins License # 4=2'D Supervisor Cert # 116 I
Mailing Address rza' I W. ,. I'C54 uITE City iKIIN0504State CO. Zip eC6-5_6
LEGAL INFO:
Subdivision/PUD 5w/R- A4Dr(7Q Q.5I L IAltFiling # Lot #--I]— Block # Lot Sq Ft I �o
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 2Z.3 3 Total Garage Sq Ft
r
Residential Sq Ft 22— Comm] Sq Ft # of Stories Bldg Height 3S # Dwelling Units /�
1 st Floor Sq Ft 22��_ 2nd Floor Sq Ft Unfinished Bsmt Sq Ft 1J� Finished Bsmt Sq Ft Ye
# of Bedrooms 3 # of Full Baths 3/a Baths /z Baths # of Fireplaces
Air Conditioning: CYes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door �-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO: U
Water Tap Size Sewer Tap Size Metere . Yes r No Temp. Pedesta . Yes Abr No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 00 Amp ❑ Other
Value of Construction (including labor, material & profit) $ (, D t,OID
Description of Work: N � 1 tja ` lm q Kcs I alAcE
Contact Name & Phone # of JOBSITE SUPERVISOR: DhVE / "Y/YmD [ ! d— Z 7 - 3 1,3
Subcontractor Info:
Electrical JRIG3 FL67 t`IL Mechanical ?V1L(-Kiha4A/ Plumbing
Framer , C051-0Ld(_Roofing GGLOS Concrete VAif6, Other Tltv
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 5&17olfins ondinancep and state laws regulating building construction. y
Applicant Signature !/lam// /�L Print Name 0*✓/D hVVA1A& Phone ?%9 Z/�
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE