HomeMy WebLinkAbout3321 Long Creek Dr - Applications/Single Family New - 03/07/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
CityofFodCollins BUILDING PERMIT APPLICATION
& 04 83
APPLICATION NUMBER 6 0q o Ian t APPLICATION DATE !�> � I � V
Job Site Address .36 L I Lo+aL, U12 Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional)
Last Name SAME First Name
Phone #
Middle
Street Address City State Zip.
CONTRACTOR INFO: Company Name iZIJ1.1slkr r`e siR�'1m�lswtractor Phone # ZZ-4q-%4q(0
Lic. Holder Name City of Fort Collins License # CZ� Supervisor Cert # (08
Mailing Address 3 7 5aMr.-9- City L1>Va�,At4(> State try Zip SOW
LEGAL INFO:
Subdivision/PUD V)C)&S iL 1,1l POO Filing # L 2 Lot # V Z Block # 3 Lot Sq Ft 8,467
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 21 (03(o Total Garage Sq Ft 672—
Residential Sq Ft ? Comm'I Sq Ft` 9 # of Stories - 2, Bldg Height 7' # Dwelling Units
1st Floor Sq Ft Q 12. 2nd Floor Sq Ft rZ53 Unfinished Bsmt Sq Ft Iy 3iZ Finished Bsmt Sq Ft _0
# of Bedrooms # of. Full Baths % Baths 1 /z Baths 0 # of Fireplaces
Air Conditioning: es No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door E-Star w/Blower Doo 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door .
City of Fort Collins Stock Plan # • List appropriate option
UTILITIES INFO:
Water Tap Size Sewer Tap Size _ Metered: ®e or No Temp. Pedestal: e&s or No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential '
only): ❑ 150 Amp or Less zoo Amp [I Other
Value of Construction (including labor, material & profit) $ �C71q xtl,
Description
Contact Name & Phone # of JOBSITE SUPERVISOR: T1GJ.L BVAI.LSiz►Zl 5(01- lg4s
Subcontractor Info
Electrical A5A Mechanical Gla'sDti( , Plumbing ?51
. Framer Jk 1 N0WT'0N Roofing (4l.� `Y dConcrete A94A5 Other I_jy
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to commyv,�i�tvat�ieQctire�dnhr
contained herein and City of Fort Collins ordinances and state laws reculating building construction. C/� �"� 1
Applicant Signature `j/vr��� / ` '1.-- Print Name ! EM Z12l;AJSFX KF Phone 5t0j—Ia45
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE