HomeMy WebLinkAbout6139 Carmichael St - Applications/Patio Cover Or Sun Shade - 03/15/2006BUILDING 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 �� 600 ` l ' APPLICATION DATE
Job Site Address 413I CWMIdArJ S-j. — kY, 6111 Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional)) Phone # D'0
Last Name n First Name --Dr/ V lb / Middle L
Street Addressj 3 9�11�li3� CitState Zip
CONTRACTOR INFO: Company Name fit/t d 1J1 E C� fl'Yt_� Contractor Phone # �U ' 7' �B—S
Lic. Holder Name City of Fort Collins License# Supervisor Certt##
Mailing Address I S 2 � M/cl}vgl City 5 2 � L/l/per State_ Zip S—.;?Op
LEGAL INFO:
Subdivision/PUD�( �/i.5' �Ci l�i� 6(0? / Filing # Lot #--�— Block #— I— Lot Sq Ft `� �t✓
CONSTRUCTION INFO: 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
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/ 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: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ 2 7
Description of Work: 0 A .-I() lel 9- /
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Other
Applicant: I hereby acknowledge that I hav r ad this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fo Ilins r ' anc nd tate la gulating building construction.
Applicant Signature Print Name ✓�%(�C�(/yC� �/�'b( Phone Q2D-,?W-?49,S
Distributio . ' e-�9f Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE