HomeMy WebLinkAbout430 Albion Way - Applications/Deck - 09/19/2008BUILDING PERMITS & INSPECTIONS DIVISION
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PO Box580 FortCollins CO80522-0580 Phone 2216760 www fcgov com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 5 APPLICATION DATE Z Z / 2 0 k
Job Site Address "7 3 0 A 16,0 ,11,1 06 Unit #
PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone #
Last Name AM/ %�Da First Name ���KA-L Middle
Street Address Ll-y !41 i D`< zAJ / City_ �Z--6 & 1-S State (0 Zip (30
CONTRACTOR INFO Company Name /O%�A� �t/JD4'--�tnlr7PkS Contractor Phone # 9'1770 5-6G /j21
Lic Holder Name City of Fort Collins License #�- �9� Supervisor Cert #
Mailing Address City�� 7����/K State �� Zip
LEGAL INFO
Subdivision/PUD 74 Filing # Lot # Block # Lot Sq Ft
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CONSTRUCTION INFO To Builds Sq Ft (not including basement) //02O s9 l Total Garage Sq Ft
Residential Sq Ft
151 Floor Sq Ft
# of Bedrooms
Air Conditioning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
Comm I Sq Ft
2nd Floor Sq Ft
# of Full Baths
# of Stones Bldg Height # Dwelling Units
Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
% Baths '/z Baths # of Fireplaces
Energy info (Circle appropnate choice) 1 ComCheck 2 ResCheck w/Air Sealing
4 E Star w/Blower Door 5 Prescriptive w/Air Sealing 6 Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size
List appropriate option #s
Metered Yes or No Temp Pedestal Yes or No
Type of Heat ❑ Gas ❑ Electric Electric Main Breaker Size (Reside ttt,6only) ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
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Value of Construction (including labor material & profit) $ t,)Oa
Description of Work /&,P 1A C aM eA/ 7J 4—,)5— c-k ( .4-0
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 City of Fort Cqj4qs ordinan es and s regulating building construction g
Applicant Signa Print Name rf c /'C' Phone/ "D.S�o�/���
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE