HomeMy WebLinkAbout1942 Constitution Ave - Applications/Shed - 07/29/2008BUILDING 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 O v 4 ✓ l / APPLICATION DATE —7 — C:;?— l — OR
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name, 7 � &-e— r- First Name 1ze r-Middle 141
U l �
Street Address / 9'�,2 C,U vi ,s '( � o�+ t&y__erz 6 State 00 Zip_g: s L
CONTRACTOR INFO: Company Name =� / Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing
LEGALINFO:
City
State Zip
Subdivision/PUD �( 4 -e— Filing # Lot #_2Z_ Block # Lot Sq Ft /a -f
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) oe y J6. F�i , Total Garage Sq Ft
fBu�S i
Residential Sq Ft omm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Fl: Inis e sm q S F
# of Bedrooms —3 # of Full Baths 3/< Baths /z Baths # of Fireplaces
Air Conditioning: ( Y�, 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
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Ye or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas XElectric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ) 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 1 -7 FD
Description of Work: %6 . ����r- 42 P-i2Y yrjG �21� i �. n �'� S el
Contact Name & Phone # of JOBSITE SUPERVISOR:_�_a /'Z--��„_
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Roofing Concrete Other
Applicant: I hereby acknowled 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 o Collins ordinances and ws regulating building construction.
Applicant Signature Print Namey0.re-l( A. Phone 97o"ZIV -%Sl
tributio White —Office Yellow —Applicant Pink — WWW/Stormwater
TH19 APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE