HomeMy WebLinkAbout1409 Rollingwood Ln - Applications/Addition or Alteration - 04/09/2007BUILDING 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 APPLICATION
APPLICATION NUMBER TF>0 !/O O ! O APPLICATION DATE 6 - O `
Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #'17v -0--2
Last Name C-XyddMt-�M-tZi First Name Middle
Street Address Cold ti2!nk-P G� City ��~Cc�l (I h S State ("o a Zip
CONTRACTOR INFO: Company Name.J/p+ t�=�pSES oritractort Phone#
Lic. Holder Name JAY �T, JtfC/ City of Fort Collins License #.>/ 4-1 q1 Supervisor Cert #
Mailing Address �� I S �'' f �`'' -� <:"rt ' City a co=�I t "7S State <�= Zip ?=vt� Z)
LEGALINFO:
'
Subdivision/PUD �6 �{"���
Filing # In Lot # 1
Block # Lot Sq Ft-211 5 a�
0
CMS
SF-
" 1
CONSTRUCTION INFO: Total Building Sq Ft (not including
basement)
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft
# of Stories Bldg Height
# Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft
Unfinished Bsmt Sq Ft
Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths
3/4 Baths /2 Baths # of Fireplaces
�t )
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
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 11200 Amp ❑ Other
Value of Construction (including labor, material & profit)
$
Description of Work: Gp! J ' ('i CS- .
i I
2-c-�P K -2-4 G i71
l tea.— -�� t4n'-y
Contact Name & Phone # of JOBSITE SUPERVISOR: �� C,-� — �-
subcontractor �-,Info:
Electrical)`+�f-- d '
Framer Roofing
Mechanical
lip
Plumbing 5�� IZ1
Concreteit;;, 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 Signatlte__ ~IAA/ Print Names /�I � ri+� hone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE