HomeMy WebLinkAbout3615 Silvertip Pl - Applications/Addition or Alteration - 09/28/2007BUILDING PERMITS & INSPECTIONS DiViSION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER '1 / ` ) ! `- �/ L APPLICATION DATE " C? 7
Job Site Address 36 1 -c;� S I wr-2 r t PL Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # -7 l cl - Z 7-`f - L `1 a 9
Last Name K (7 i First Name C kA-P—k S Middle R O S b 2T
Street Addres CityrojLT r 1 r S State CO Zip aS2
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGALINFO:
Subdivision/PUD Eox MEAa(66 Filing # �Aa Lot #_'V_ Block # Lot Sq Ft -7-7-14
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 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/z Baths # of Fireplaces
Air Conditioning: e 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 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILMES 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): 11150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) ;_ to O U
Description of Work:_r-yTr-A►p a awNsC4�R5 AL Ac: -,h 0oM A-0 L4I Y kA " ANt
PL.SjMA-'rJb 1p""X P,�«rat_[= 1=vr�dLr= 1� era-c.���J of aaAtTt�sl.4( i t..rv2c
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Contact NarAe & Phone # of JOBSITE SUPERVISOR: CL-J k S K IZ. ir-R L 5 I
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete 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 ort Collins ordinances and state laws regulating building construction.
Applicant Signature ! Print Name G+&"S (� �Z� iZ Phone - z(- Z q "2-101
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE