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HomeMy WebLinkAbout508 W Trilby Rd - Applications/Addition or Alteration - 12/09/2005BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: Z21-6760 www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER ��) C� ` APPLICATION DATE /O� q— Job Site Address SD1B V Tj LLf C Z4A-P Unit # PROPERTY OWNER INFO: (All owner information is r qu�ir+eMd -- it is not optional) P one # &0 � 3( Z 3lW X*,J f4v& Last Name is NameD Middle Street Address <0V /i L-ai City - (200d 5 State W Zip D-5,5- CONTRACTOR INFO: Company Name D Contractor Phone # Lic. Holder Name Mailing Add City of Fort Collins License #. City Supervisor Cert # ' State Zip —' LEGALINFO: pSSr'.�S�ILS �J At0r 9b1/1/-.30-7,,O.Z- 7rA 0'IS U1101-6 F FIICSi SO rR �I Uf 510 � C©v.tr`ie f L14+�1r� EdC S!►4Tt,/firr Subdivisi&n/PUD Filing # Lot # Block # Lot Sq FtJD CONSTRUCTION INFO: Total Building Sq Ft (not including basement) qe.S4 ff Total Garage Sq Ft�� Residential Sq Ft Comm] Sq Ft # of StoriesBldg Height #Dwelling Units 1sl Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft. # of Bedrooms Air Conditioning: Yes No 3. ResCheck w/Blower Door City of Fort Collins Stock Plan # UTILITIES INFO• # of Full Baths % Baths '/2 Baths Energy info: (Circle appropriate choice) 1. ComCheck # of Fireplaces 2. ResCheck w/Air Sealing 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door List appropriate option #s , \� t y� Water Tap Size Sewer Tap Size N r I Metered: Yes or No Temp. Pedestal: Yes or No Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ (/0, 000 Description of Work: 4.06417e A44 6QV01AM 54 %--:5-jOL7' ' X Jt' d-;0VM N f L-S 4�j ZWA j - /2/j D&dTS 4hC Ttf15 % f7�xtV ���h6iK'j_r 4. E-Star w/Blower Door Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Mechanical t 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 Fort Collins ordinances and state laws regulating building coo)�5467WFQWAQF�_ nstruuction.,�✓✓ �yApplicant Signature l� !'0EY LPrint Name -r Phone 303.7("W /ftl Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE