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HomeMy WebLinkAbout2627 Thoreau Dr - Applications/Single Family New - 04/13/2007BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLIC TN I APPLICATION NUMBER �O l%j APPLICATION DATE Job Site Address ;) U a1 V"p«A-Lk, I)C . Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Last Name S6u4n ON` , First Name Phone '6{(3-0 Middle Street Address -)a5I ((f . �T. City (are 2.1 fA- // State ( L) zip FOL0ZLI CONTRACTOR INFO: Company Name �LA, 1 q >A mnn� � Contractor Phone # (°►�N)L b "5 Ll &D Lic. Holder Namea/,aAa 1 Y l L City of Fort Collins License # 5 7 Supervisor Certt # >u Mailing Address � a� I u) � S+ 3W City �-1t"U= C t State 6 zip Mq LEGALINFO: ly j0 61 Subdivision/PUD� 1 1I Filing #) J" Lot # Block #y�_ Lot Sq Ft CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 1 / 4� Total Garage Sq Ft (D b U Residential Sq Ft I LJC6 Comm] Sq Ft # of Stories a r a Bldg Height_ # Dwelling Units 1st Floor Sq Ft NI¢ t/ 2nd Floor Sq Ft gQL4 Unfinished Bsmt Sq Ft n D Lt Finished Bsmt Sq Ft # of Bedrooms � # of Full Baths Q 1/4 Baths 1 /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 (4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # I -� y� List appropriate option #s l - UTILITIES INFO: u l� t/ Water Tap Size '�' �LSewer Tap Size i Metered: Yes or No Temp. Pedestal: Ye r No Type of Heat: VGas ❑ Electric Electric Main Breaker Size (Residential only): r 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ 1 Q6i , (n C)C9 - I Q © U-"" b'r �PIm fu �nK Description of Work: Contact Name & Phone # of JOBSITE SUPERVISOR: _ In u e, 0Lyarad o ( c, -7015 l 0/' 01, 2 Subcontractor Info: Electrical �1-SkeS�� i� Mechanical --t YES hn 4- t(' Plumbing Framer Roofing h AtAr'C AIDS �lCxi14Concrete (j2S4- T.hj' 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 f4n , AAz!h_LAa4fU _) v Print Namer&U.r& W, (GarrIS Phone q-1b - ✓-1, Distribution: White — Office Yellow —Applicant.-,,. Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE