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HomeMy WebLinkAbout3744 Eclipse Ln - Applications/Single Family New - 03/16/2006BUILDING 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 50`t'010(01 APPLICATION DATE �'Io�e Job Site Address e74q ) Unit # PROPERTY OWNER INFO: (A I owner information is required - it is not optional) Phone # ,;) 7 7 Last Name First .Name Middle /� � Street Addres � ©b City Stateco Zip D` b j�j�,,�,, / / , I CONTRACTOR INFO: Company Name ��, 1 tLY J leS Contractor Phone #- JL4) 9 i D) �1 Lic. Holder Name I N-U/L —\ City of Fort Collins License #(,Qq _ Supervisor Cert # Mailing Address City State Zip LEGAL INFO: / I Subdivision/PUD D. Filing # / Lot #_ I Block #- a— Lot Sq Ft,4511)4) CONSTRUCTION INFO: Total Building Sq Ft (not including basement) r�`Y� i Total Garage Sq Ft� , � t . Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height Is "-# # Dwelling Units. 1st Floor Sq Ft / ZZ�C 2nd Floor Sq Ft Unfinished Bsmt Sq Ft rigs Finished Bsmt.Sq Ft i J # of Bedrooms t # of Full Baths % Baths 'Y2 Baths # of Fireplaces (/ Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door �E-Star//lower Door 5. Prescriptive w/Air Seali1ng� 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # A - g List appropriate option #s '�r 'r UTILITIES INFO: Water Tap Size __ Sewer Tap Size / Metered Yes or No Temp. Pedestal: a or No Type of Heat: I�as ❑ Electric Electric Main Breaker Size (Residential only): 150 Amp or Less. / ❑j 200 Amp ❑ Other Value of Construction (including labor, material & profit) $�^ Description of Work:. 3/ )qo./ Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical %� Mechanical r l-e.0 , Loy\- Plumbing Framer Roofing . t 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 C/e` CityofFort Collins ordinan s and state laws regulating building cc pnsstr�ujction.. Applicant Signatu e✓ � " Print Nam'"''`�� "`C` Phon V1� Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE