HomeMy WebLinkAbout501 Affirmed Ct - Applications/Patio Cover Or Sun Shade - 04/17/2007Job Site Address Sal AlEr ern C+ F-V. & kns Cn 91)S nit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # gJD- a// P /SS-o17
Last Name 1e ela;r First Name AG ro✓1 Middle x"r- NG
Street Address%n7�_ �/ - T City /C�� ��%IL State-eldzip l%S '?s
CONTRACTOR INFO: Company Name
Lic. Holder
Mailing Add
Contractor Phone
City of Fort Collins License # Supervisor Cert #
City
LEGAL INFO:
Subdivision/PUD Filing #_
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm] Sq
1 st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
# of Full Baths
State Zip
Lot # Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft . Y Finished Bsmt Sq Ft
_ %,, Baths /z Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size
List appropriate option
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
Value of Construction (including labor, material &profit) $ / 61 / d /
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Mechanical
Plumbing
Framer Roofing Concrete Other
Applicant: I hereby acknowle5oe that I hav read this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of rt Collins c read
a ind state laws regulating building construction. p,Q
nature Applicant SigPrint Name h 6i Clw f %' Phone // 2-f 553 y
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE