HomeMy WebLinkAbout2521 Custer Dr - Applications/Single Family New - 06/19/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box580 • Fort Collins, CO80522-0580 • Phone:221-6760
www-fcg0v.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER (J4V32\_ 4 ^
y a
APPLICATION DATE —V
Job Site Address _ � i u f •P
Unit # —AM
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
J i�>LiJf�l-��`foTZ
Last Name [,,ri First Name-jU►•j'tAJ � MiddleV
Street Address 1100 tjems City coel
T �_ State 60 Zip
CONTRACTOR INFO: Company Name .='beg iE0—)*a7le S &;tractor Phone
Lic. Holder Named
Mailing Address I'i� `Y.,>7 y City of Fort Collins License # /
Supervisor Cart #
19�D � �
C —w6w, ity_ �(g C (1i .l� State_L Zip_
LEGAL INFO: S
Subdivision/PUD—Q1&n6w_EhRjlq�t. Filingy�
_ # �Lot #�(� Block # Lot Sq Ft
CONSTRUCTION INFO Total Building Sq Ft (not including basement) _ f ` '37
Total Garage Sq Ft '',
Residential Sq Ft� Comm'I Sq Ft J,A,/,� # of Stories_ c�
V,LL— Bldg Height 7, J #Dwelling Units
1s' Floor Sq Ft 7n 2nd Floor Sq Ft Unfinished Bsmt Sq Ft
�_ Finished Bsmt Sq Ft
# of Bedrooms 3— # of Full Baths_
'/, Baths �_ /Baths �_ # of Fireplaces
Air Conditioning: Yes (N Energy in Circle a ( ppropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing w
3. ResCheck w/Blower Door 4. E-Star w/Blower Door ti
Prescri
5. Prescriptive w/Air Sealing +
/ 9 prescriptive w/Blower Door
City of Fort Collins Stock Plan # I I C4 List appropriate option #s_
UTILITIES INFO -
Water Tap Size _� Sewer Tap Size �
Metered: � or No Temp. Pedestal: 'lam' or No
Type of Heat: $/Gas ❑ Electric Electric Main Breaker Size (Residential only): ,�
t/ Y)� Jg150 Amp or Less ❑ 200 Amp ❑Other
Value of Construction (including labor, material & profit)
Description of Work:--?��Of2 Y -c< I uVGJ.z L�! ✓n i, �� ; l.� n , _
Contact Name & Phone # of JOBSITE SUPERVISOR: TJd/7 Vj ,0/ Gj70a:3J Q�
Subcontractor Info: ��
Electrical r—LT� ([,
Mechanical0%—C44 IA G 0,L Plumbing L1
Framer(_(?JVKjpy ���,I t;`)LT IW Roofin L��l
lyjl
g Tti-- a � — Concrete j/Au�-I 1 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_ , )h 14A) 14 /)' 44 y Phone 7
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater ` f
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE