HomeMy WebLinkAbout5433 Northern Lights Dr - Applications/Patio Cover Or Sun Shade - 05/10/2006BUILDING 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 LJ p APPLICATION DATE V G O v 0 (Q
Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # f� • � /3, • [A /
Last Name t64�/gi! a_,5_ First Name �f% Middle ET-14A—
Street Address �7�� %lkerlf, 2I?n 0 DCcity)Seer t!'g/ I State4�9 Zip M54—
CONTRACTOR INFO: Company Name
Lic. Holder Name
Mailing Add
Contractor Phone #
City of Fort Collins License #
City
LEGAL INFO: `` ""�
Subdivision/PUD [AdOXA) 81-0 k ,,, Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement).
Residential Sq Ft Comm'I Sq
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 #.
State Zip
Block # Lot Sq Ft
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths % Baths '/z 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
List appropriate option #s,
6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work: .c�l�Sh� � 1-1���
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
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 ?Ay of Fort Collins ordinances and state laws regulating building construction. may,
Applicant Signature Print Name &j Phone'<p.
�stribubon:. White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE