HomeMy WebLinkAbout1597 City Park Ave - Applications/New Commercial - 04/10/2006t) BUILDING PERMITS & INSPECTIONS DIVISION
�rP.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER 0 !�l 11 60 11,APPLICATION DATE ` / t O I O
Job Site Address k 5 "(7 C, V j Pa, 1c Q v Q . Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) \ Phone #
Last Name C 1 A J A To k Co 1 l 1 First jName_ _V\' %- C -..- e. cx'1 i o v, Middle � q %�4-ak C S
Street Address 2 f L4 M . k 0 c-� C S !pST City P o State60 zip lgdsz
CONTRACTOR INFO: Company Name �. I�V a'T t d .� Ca`� t v�P Contractor Phone # (I -TO) 2-2 1 - ic,50!37
Lic. Holder Name_ 9. Cd Vx h Q CCity of Fort Collins License # C.�—$3 Supervisor Cert #
Mailing Address Q .0. `k7 W . Mci Jvu SI .City ]Pa ,' -C-.o l I L v f State C-0 zip S d , Z 2
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) N I A Total Garage Sq Ft N / A
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height_ # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# 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
UTILITIES INFO: iJ / P1.
Water Tap Size Sewer Tap Size i Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size ('t Rrresiidential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
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Value of Construction (including labor, material & profit) $ *2 G (p s Q
Contact Name & Phone # of JOBSITE SUPERVISOR: Q C�1 T e Z Z 1 -- (e,R
Subcontractor Info: F'r y, cn CR.L. c
' s y� A
Electrical \ C r-k vti S O „; Mechanical N / N Plumbing / A
/ Pooi "j j, C�ljk �
Framer � �, Roofing N A; Concrete �ZC r0 -r Q.f S Other ►d
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 Cit of Fort Collins ordinance and state laws regulating building construction.
Applicant Signature Print Name C', Phone Z.2-
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE