HomeMy WebLinkAbout848 Rumford Ln - Applications/Patio Cover Or Sun Shade - 05/08/2006BUILDING 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 IS00 2 I ( I APPLICATION DATE '5 —i� —n Ca
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone #
Last Name ( Oz ,First Name �1 Middle --
Street Address a �/e1� UCJ City �"r l� �1 i�� State —Zip
CONTRACTOR INFO: Company Name Contractor Phone #
Lic. Holder Name ty of Fort Collins License #,
Mailing Address / ! City
State
LEGAL INFO: -
Subdivision/PUD�ti�(//I,kTDt41,t% Filing #�� Lot # Block #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Supervisor Cert #,
Zip
Lot Sq Ft/2
Q
Total Garage Sq Ft I`
Comm'I Sq Ft of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft nfinished Bsmt Sq Ft Finished Bsmt Sq Ft
_ # of Full Baths 3/< Baths '/z Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blovy�rAo 5. Prescriptive w/Air Sealing
�V List 'appropriate option #s
Water Tap Size Sewer Tap Size Metered: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker �e (Residential only
d, _ i le 'G
Value of Construction (including labor, material & profit) $
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
Temp. Pedestal: Yes or No
❑ 150 Amp or Less ❑ 200 Amp ❑ Other
aK
ILA �O )( ZZ
Mechanical Plumbing
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 Cit o ort Collins or nces and state laws regulating building cons uction. 1
Applicant Signat Print Na V^) Phone Z -5
I
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE