HomeMy WebLinkAbout711 W Mountain Ave - Applications/Addition or Alteration - 09/02/2005�tix' a BUILDING 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 a560gi APPLICATION DATE 6� o 5
Job Site Address '71 j W) %uu",, Awe_ A 6114-Unit# /,
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 't to
Last Name :�tNAV- First Name S"-fT- � 31ovA-A- Middle
Street Address `1(( GJ, 0xkt t^.:. Art State Zip g�_
CONTRACTOR INFO: Company Name d Contractor Phone # It 5—'(016
Lic. Holder Name
Mailing Address
City of Fort Collins License # Supervisor Cert #
City,
State
LEGAL INFO:
Subdivision/PUD �l' 2' Filing # Lot # A S Block # 740
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft _
# of Bedrooms
Zip
Lot Sq Ft ( 0134 0
Total Garage Sq Ft
Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
Air Conditioning: Yes 93
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
# of Full Baths % Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s,
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: 'R Gas ❑ Electric Electric Main Breaker Size (Residential only):)W 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work: -P., `,-, l `Aw &22
M(1— r P�K 1 "401" 4 1"1 /tile44-1
Contact Name & Phone # of JOBSITE SUPERVISOR: 0L3At/ ���' ��O♦i
Subcontractor Info:
Electrical
Mechanical
Plumbing
Framer Roofing Concrete 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 F rt Collins ordinances and state laws regulating building construction.
Applicant Signature �V d Print Name J! il5 Phone 124 -0511
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE