HomeMy WebLinkAbout3303 Buteos Ct - Applications/Single Family New - 06/13/2007APPLICATION N
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION
Job Site Address IS � 'f� O S Unit # -7
PROPERTY OWYveL
NER INFO: (All owne infor ation is required - it is not oI tonal) Phone # -C 16'a� 1 -7 1 a b
Last Name 4 Gam' �� -First Name u � l `� Middle
Street Address cal �- °`GI S ity ma it State J Zip L) ,
CONTRACTOR INFO: Company Name
Lic. Holder
Mailing Add
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
City_
State Zip
LEGAL INFO:
Subdivision/PUD� Filing # 2 Lot # LA() Block # Lot Sq FAN
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) .,� / �U Total Garage Sq Ft g LL t
Residential Sq Ft Comm'I Sq Ft ,r # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft !� 2nd Floor Sq Ft is Jy Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of. Full Baths_ 3/ Baths '/3 Baths I— # of Fireplaces
Air Conditioning: 9 No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing Pre�w/BlowerDoor
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: e r No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 00 Amp ❑ Other
C%i— -
Value of Construction (including labor, material & profit)
Description of,Work: n,"AL�[?./ivt�n,�Ld .
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
\ n y��
Electrical 1— 5 Mechanical I YJJ� ire (Z Y� A5; Plumbing b I � r
Framer CL) KS VaAZ #Roofing Concrete MAe1LFLj-0kT`Other
Applicant: 1 hereby acknowledge that I have read this application and state that the above information is correct d agree comply with all requirements
contained herein and City of Foq follins ordinances and state laws regulating building construction. (, ruction. Ik e r -�- �7
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Applicant Signature Print Name U%` lI `AA L-O "" hone q / 0 ; tea 7�
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater / / 4
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE FAX ZZ42
604/