HomeMy WebLinkAbout1309 W Mountain Ave - Applications/Garage - 09/21/2007City of Fort Collins
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER CIJb /L O Y 7 APPLICATION DATE ! C� / o�
Job Site Address 3yq h/ t- Unit #
'744
PROPERTY OWNPR INFO: (All owner information is required — it its not optional) Phone #
Last Name SC t, fac" First Name GA_vtrC\_
Middle Street Address 1, oy Li ri cDrFAV, City 7pT 4!5�)�f ti5 G State C> Zip oaS_°L
CONTRACTOR INFO: Company Name l Q��\ W'vrrG�<<� Contractor Phone # �q —
Lic. Holder NameGe"oc( Cd�r��{,"(/T��/ City of Fort Collins License # D�Sq* Supervisor Cert #
Mailing Address `SS S 1 t� j City T 61kw State 6%.) Zi 74-KOL
P
LEGALINFO: ,�,�
Subdivision/PUD " ' �O " �' Filing # Lot # Block #�(�_ Lot Sq Ft q "oD
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) _ Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths /z 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
List appropriate option #s
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 Constructionk
including labor, mate I & profit) $ 000
Description of Work:&./ TI;7 A 4&c 1I/ t"j ()AVIVAC
,4-i�lG-- ®t* IM YL 0- 3 N n . F .. AV10
Contact Name & Phone # of JOBSITE SUPERVISOR: 7f
Subcontractor Info:
Electrical Mechanical Plumbing
Framer eno Roofing eAt) Concrete w a Z0'
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 F rt Collins ordinances and state laws regulating building construction. `1
Applicant Signature Print Name "Toray (�C/ttrG� Phone v "J7/t 07"13
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE