Loading...
HomeMy WebLinkAbout3133 Chase Dr - Applications/Single Family New - 03/27/2006BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 Y, y www fcgov com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER APPLICATION DATE D Job Site Address�334E _i o Unit # PROPERTY Q NER INFO: (All owner information is required — it is not optional) Phone # � "L4 o— R3 Last Name Street Add Lic. Holder Name Mailing Address Name MiddlE City_ State 010 Zip Contractor Phone # , City of Fort Collins License # � ©� Supervisor Cert #Ca — City State Zip LEGAL INFO: Subdivision/PUD 1 Vr V t� Filing Lot # `.J'"Tt Block # L 9 T O of q Ft CONSTRUCTION INFO: Total Building Sq Ft (not including baseme ) Total Garage Sq Ft I Residential Sq Ft Comm'I Sq Ft ff # tones Bldg HeightQ�-3 # Dwelling Units 1st Floor Sq Ft 2nd Floor Sq Ft I 11�4 q Unfinished Bsmt Sq Ft_1 ! LO -i- Finished Bsmt Sq Ft _ # of Bedrooms # of Full Baths CD 3/4 Baths ( 'Y2 Baths # of Fireplaces Air Conditioning: YeTNo A4.w/Blower f • Circle a ropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door r 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan #List appropriate option #s Q� �T� ( 0� UTILITIES INFO: Water Tap Size Sewer Tap Size 't Metered G or No Temp. Pedesta Yes or No Type of Heat: Gas ❑ Electric Electric Main Breaker Size1Residential only 150 Amp or Less ❑ 200 Amp ❑ Other Value of Constructier,(including labor, material & profit) $ _a 9 Tz Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrica Frameroofing Applicant: I hereby acknowledge that 1 have read this application and state that the above information is correct and agree to comply with all requirements contained hereEure nd f Fort Collins nances and state laws regulating buildi nstruction. Applicant Sig Print Name Phone - 3 Distribu ' n: White - Office Yellow - Applicant Pink - WWW/Stormwater K 4 THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE