HomeMy WebLinkAbout2620 Thoreau Dr - Applications/Single Family New - 04/12/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
CitvnfFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER / APPLICATION DATE
Job Site Address C4. Unit # -
PROPERTY/OWNER INFO: (All owner information is required - it is not optional)
Last Name U7 .4 First Name
Phone -70 %Q�
Middle
Street Address d#t�2CityA" /7 State(,Zip d
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder NamCd�. City of Fort Collins License # Supervisor Cent #�-'?/„/O
Mailing Address ,Q&Yy> e City
LEGAL INFO:
State
Subdivision/PUD I '16 n,/o Filing # Lot # 9 Block # JC Lot Sq Ft 1,0119
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1405 Total Garage Sq Ft 6n�
Residential Sq Ft IS Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq FtSL%(< 3`j 2nd Floor Sq Ft Unfinished Bsmt Sq Ft SQU Finished Bsmt Sq Ft —'
# of Bedrooms # of Full Baths 3/4 Baths — '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door OE -Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # 1 74P List appropriate option #s
UTILITIES INFO:
Water Tap Size ���{ Sewer Tap Size " Metered: eyg�S7)or No Temp. Pedestal: es r No
Type of Heat: ,`Gas ❑ Electric Electric Main Breaker Size (Residential only): IfY150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
Description of Work: /%/1),e0iJ1/yZe01
Lz /� itGQE-(ii�
Contact Name & Phone # of JOBSITE SUPERVISOR: diex- a,4) 0% )':532-ao
Subcontractor Info:
Electricak-- t"L&4- 1, .e,z <_'Lit -cam Mechanical 11 1 C-�5 t(.00L A4 Plumbing
� //S)
V� /
Framer h Roofing ce. ' 'Concrete 0.Q�$ -6L - J?A/4 e 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 a r, fDh'd':a Print Name ��ht/(Y��iL% Phone �� "707.17
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE