HomeMy WebLinkAbout5201 Mail Creek Ln - Applications/Shed - 01/05/2006BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 a Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
Job Site Address _' 111G1,k� CxeJL LV% Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # —IT7(br U-1; r
Last Name G" 1FAG A First Name �� Middle `..�
Street Address 6�` j�(�t.�, � G �,(_, L" City �O u1U� S StateC0 Zip&15.z-
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Address_
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License #
City.
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft
1st Floor Sq Ft
Supervisor Cert #
State Zip
"J
Block # Lot Sq Ft
Total Garage Sq Ft
# Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces �^�
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing " )
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # List appropriate option #s V
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas 1A Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ .1,42y 00
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Description of Work: CO M� + jely-&,Lk 5�/wOV k -5 1 (-EL ( K 6"L LG r CA
lam] u tp t ti 4 R 'k 1P, 1- L., S ex-M i< h tj hn ilA ew
Contact Name & Phone # of JOBSITE SUPERVISOR:
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 Fort Collins ordinances and state laws regulating building construction. �/
Applicant Signature Vw �L 1vWl�ic� Print Name M• �e 0Ii0r�(At Phone t, 70 223-5Z-5
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE
# of Stories Bldg Height