HomeMy WebLinkAbout605 Mathews St - Applications/Addition or Alteration - 01/09/2008BUILDING 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 (J 91 ll L l . APPLICATION DATE / — 7-de
�ob Site Address 16 0 S M c. +1^ -p w S j+ f-A C ,:o i I "� S Unit # 8
^_
'i
ROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # .1 7 L - Y 7C
.3
Last Name U k "1 j 7 u in First Name C(1 1 `� Middle Street Address �• �3 o X Z 9 ,', ) ( Cit6,1A o State C/o zip F�
CONTRACTOR INFO: Company Name S 1 T Contractor Phone #
Lic. Holder
Mailing Address
Subdivis
City of Fort Collins License # Supervisor Cert #.
State zip,
Filing # Lot # Block # Lot Sq Ft
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 Yz Baths
# of Fireplaces
Air Conditioning: Yes
No rgy info: (Circle appropriate choice) 1. ComCheck
2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
4. E-Star lower Door
5. Prescriptive w/Air Sealing
6. Prescriptive w/Blower 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: ❑ Gas ❑ Electric Electric Main Breaker Nze (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
/(slue of Construction (including labor, material & profit) $ 13 -s 0, 0 0
Description of Work: f N S. + r v <' + t, r i v �'? :• ;` {.— i.t. r_ �i S �• I ) �Cf 1 4- 4 n TO
'' 11 !% \� i 1 Q Ct/. " 3 n 1i f:1� 'J.t� v� / Li. "1 Y % ,� U �� /.� f G1 . (^..'ti t l ,7• 1
•�: t i :r "' t l� ���ci/ ��ii Vc �.l' !{1f� P< �RC w:�COa in
lot roo 4a .tee ei- eq/1P3S 'S>ta,dar S
Contact Name & Phone # of JOBSITE SUPERVISOR; /�' �' 4R ✓ �'ti Y �• y I i t i
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 City of Fort Collins 7dinances and state laws regulating building construction. y /�
Applicant Signature Print Name / R of No S� Phone y7 3 O 6 6 Z
tribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE