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HomeMy WebLinkAbout2650 Thoreau Dr - Applications/Single Family New - 04/19/2007BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building CityofFort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER BO ! Ot9 � APPLICATION DATE �127 Job Site Address :�& Jth/t1 GJ'a /,(fir. Unit # PROPERTY OWNER INFO: ,(All owner information is required - it is not optional) Last Name //JZ.UL12�cy h�(�7�22A � First Name Phone W9 7415 3�? - .S4 "P(_) Middle —f Y Street Address n5! �) l?�2Uy City State zip O CONTRACTOR INFO: Company Name tVhct i (J7h2vie Contractor Phone # Lic. Holder Name Il )Q/12L.CQ, %LCC'+1/L� City of Fort Collins License # Supervisor Cert # lo Mailing Address �a$/ `j�, j�:' � QQ�A City_A"Ix.z State zip Y663e- Gr LEGALINFO: 'r Subdivision/PUD TIoulo a `4aL Filing # Lot # Block # r Lot Sq Ft 6010 CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �� Total Garage Sq Ft Residential Sq Ft CLO Comm'I Sq Ft # of Stories�Q Bldg Height c::24 I # Dwelling Units / 1st Floor Sq Ft ©3 2nd Floor Sq FtUnfinished Bsmt Sq Ft_1(_ Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/< Baths /2 Baths # of Fireplaces Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door (j4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # 11745 List appropriate option #s UTILITIES INFO: Water Tap Size 3 4% Sewer Tap Size `` Metered: es or No Temp. Pedestal: es or No Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only): id150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) Description of Work: Contact Name & Phone # of JOBSITE SUPERVISOR: C)Ll Y 12iijeo /ta 6 ! /(%i z2i3,9 - L, f 6 9 Subcontractor Info: Electrical C� '. �I�P (' (! , Mechanical I M-5 gprl im*o $'2411 Plumbing 1761) Framer s Roofing Concrete hd -1 -126141 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 Signature -C1Z Print Name Phone 0 Jr4,?6 istribution: White — Office Yellow —Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE