HomeMy WebLinkAbout2103 Joseph Allen Dr H-8 - Applications/Footing and Foundation - 08/09/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
(m!!d 6 �Wd 0 WWW.fcgov.com/building
CityofFortCollins BUILDING PERMIT APPLICATION
APPLICATION NUMBER -/ l/ ` l/ 1 ✓� APPLICATION DATE - V
Job Site Address �lD J �O� �a RIC"\ Ur �Unit #
PROPERTY OWNER INFO: (All owner information is required - it is nC)1ot optional) Phone # 143 —E)dO
t
Last Name / First Name !W✓ Middle
Street Address City j � -S k� State Zip
CONTRACTOR INFO: Company Name
Lic. Holder
Contractor Phone
City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip -
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO:
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Total Building Sq Ft (notincludingbasement) S�n Total Garage Sq Ft
— Comm'I Sq Ft u 0y # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths '/4 Baths /2 Baths # of Fireplaces
Air Conditioning: Yes 0
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
UTILITIES INFO: 0
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main BreakerSize (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction r(iincluding labor, material& profit) $ V I V
} 1 VA l
Description of Work: J`
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
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 Ci of Fort Colli s ordinan and state laws regulating building construct' n.
�•
Applicant Signa Print Name` Phone ?@ ` I
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE