HomeMy WebLinkAbout2154 Orchard Pl - Applications/Deck - 05/30/2007BUILDING PERMITS 8L INSPECTIONS DIVISION
P.O. Box 580 •Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
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CityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER V/ APPLICATION DATE - O O
Job Site Address a 5 y Ov��o�� Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #.
Last Name �/ 74 1 First Name j/ / th
3 -Q6-3
Middle
Street Address S No Wes S4' City !-1 • COJ/' hs State CO Zip 000 Sa
CONTRACTOR INFO: Compa�(
CompanyName Jl rn Nt' 1510" cOh 5T. Contractor Phone # 970 - 025-- oy9S
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Lic. Holder Name l h //' e s O ;1City of Fort Collins License # /Jp111 Supervisor Cert #
MailingAddress3a/a 14 It, in 6c-t.4 cCity F� - Collryl State C0 Zip b�Sa6'
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft \`
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units �\v
1 sc Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft J�
# of Full Baths '/< Baths / 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 +
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 ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 3 , / / o • o 0
Contact Name & Phone # of JOBSITE SUPERVISOR: JI h'1 Ne /So h ai a 7_ 0 0 06
Subcontractor Info/:` A /,t� A / �J
Electrical /IV /� Mechanical ^ N / 1 ` Plumbing /V 1' A
Framer �JV Roofing NZ A Concrete A11A 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 Print Name G✓q Ne so � Phone 7I 3 - 759S
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE