HomeMy WebLinkAbout5402 Copernicus Dr - Applications/Single Family New - 04/24/2007BUILDING PERMITS &INSPECTIONS DIVISION
� P.O. Box 580 •Fort Collins, CO 80522r0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 0o L O APPLICATION DATE D2
Job Site Address 614Ua Cbwlua.4S ()Y-LVc- Unit# 1 QQ
PROPERTY OWNER INFO: ( II owner information is required - it is not optional) Phone 4 -5 )
Last Name �0,1 First
Name Middle
/� Middle G
Street AddresstCO U LVQ f Y -*-zoo City y tul 0 t (Ynpt State -a —Zip O�
CONTRACTOR INFO: Company arrte Contractor Phone #
Lic. Holder Name Q DNt A City of Fort Collins License Supervisor Cert #
Mailing Add
City
State Zip
LEGAL INFO: Subdivision/PUD V V (Li�Q� �� Filing #I��l y� Lot # 1 Y�Y Block # v n
Lot Sq
FFt�p'V�
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) C SSTT Total Garage Sq Ft `J 1 p
Residential Sq Ft Comm'I Sq Ft # of Stories 2 Bldg Height 201 # Dwelling Units
1st Floor Sq Ft !� 2nd Floor Sq Ft Unfinished Bsmt Sq Ft I -1 � Finished Bsmt Sq Ft 1
# of Bedrooms 05 # of Full Baths 1/4 Baths '/2 Baths I # of Fireplaces \
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck
3. ResCheck w/Blower Door . E-S ar w/Blower Doo 5. Prescriptive w/Air Sealing
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
` It 1(
Water Tap Size ^�' Sewer Tap Size Metered: 9Lr No
Type of Heat: ❑it s ❑ Electric Electric Main Breaker Size si(Residential only
Value of Construction (r\I�'ncluding la � � -r O
✓bomaterial & profit) $ J-J.
OJ Description of Work: T `(S (x / IL/I It � eL?AL Rn ha 2e
Contact Name & Phone # of JOBSITE SUPERVISOR Orr
Subcontract rInfo:
Elec W
Framei; Roofing
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Temp. Pedestal: Or No
1`1150 Amp or Less ❑ 200 Amp ❑ Other
0
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 her 'nn and City Ffort Collins(�o dinan s and state laws regulating buildingc nstruction. M� � 2�
Applicant Signalt 1 1 \i Print Name� 1�'' Phon(J/ f� /
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE