HomeMy WebLinkAbout805 Birky Pl - Applications/Addition or Alteration - 12/19/2007BUILDING PERMITS & INSPECTIONS DIVISION
�,-., P.O. Box 580 • Fort Collins, CO 80522 0580 • Phone: 221-6760
www fcgov cont/building ✓i� O)
CitvofFortCollins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �� D APPLICATION DATE
Job Site Address
Uniitt�#
PROPERTY OWNER INFO: (Ali owner information is required - it is not optional) Phone # u-b-ce --7 f�
Last NameFirst Name i,A/7f� Middle
Street Address ��¢ 1 �l S t n /W City 91L t SI�f�0� a _ State 4�Zip6�
CONTRACTOR INFO: Company Name ��)(e� � CbrltPactor Phone # 14422 1.?
Lic. Holder Name l4 C Ar City of Fort CollinsolLicense # Supervisor Cart #
Mailing Address�, ayl / _ .44� City cJ� /L a / State_ Zip 5b -5'7
LEGALINFO: r, T
Subdivision/PUD `! Sum_ Filing # Lot # Block # Lot Sq Ft..h-,�-1/
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential S Ft Comm'I S Ft # of Stories /
q q —L Bldg Height_ #Dwelling Units
181 Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq FtT % Finished Bsmt Sq Ft O
# of Bedrooms '7i # of Full Baths _� % Baths '/2 Baths O # of Fireplaces
Air Conditioning: Yes Energy info: (Circle appropriate choice)TT1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck wBlower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive wBlower Door
City of Fort Collins Stock Plan # List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size. Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: KGas ❑ Electric Electric Main Breaker Size (Residential only): 1K1150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ �� Q, %5-c� O
Contact Name & Phone # of JOBSITE SUPERVISOR:
PL
Subc ntractorinfo:/I ,�
Electrical Mechani 1 /GoYii.�r/1% Plumbing / /I2P1.4 -jj/e
;!*rrnL1P- 1Framer r j r- , ,,. C Roofing Concrete 1L Other
Applicant: I hereby a nowledge that I have read this application and state that the -above information is corned and agree to comply with all requirements
contained herein and '` of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature -A. t-, J Print Name (S �2�Phone p /d
Cv /