HomeMy WebLinkAbout3262 Green Lake Dr - Applications/Garage - 03/28/2007rka
BUILDING 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 APPLICATION
APPLICATION NUMBER�V / APPLICATION DATE 3 D -
Job Site Address 326 2 "PA) `Al Unit #
PROPERTY OWNER INFO: (All owner information
/is required - it is not optional) Phone # J/J3 - S%/- f151
Last Name %�� D kA la+st Name / Middle
Street Address, .� pZ 3a7400 1City�f4/Ql State_& Zip&Z_5,3
CONTRACTOR INFO: Company Name ZZ& C��/ 07"/SY!�uPiI,Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Certc/#a,
Mailing Address %�9QD/�i ��1 City ��% SQL' State 60 Zip gf,5 d
LEGAL INFO: WOO Cy
Subdivision/PUD �%�( Filing # / Lot #_ 5- _ Block # Lot Sq Ft 02V
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 17 Total Garage Sq Ft Ity
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1 st Floor Sq Ft
# of Bedrooms
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of. Full Baths % Baths /£ 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 # List appropriate option #s S
UTILITIES INFO:
Water Tap Size Sewer Tap Size
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp Other
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Value of Construction (including labor, material & profit) $ t/Aga " ,QQtI71 ,,/4 407/0 % %/ r
Description
Contact Name & Phone # of JOBSITE SUPERVISOR: 71 ,V,-/ 91 AVI-6U
Subcontractor Info: Electrical %eke„CkA &4(o Mechanical n Plumbing
Framer � IS�n Roofing J dQl bG.l Concrete ` e4xlt er
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 W Collins ordinances and state laws regulating building construction.
Applicant Signature � � i Lr1 Print Name 76fIV �i= Phone 1)5- 7rgl
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE