HomeMy WebLinkAbout3408 Buntwing Ln - Applications/Deck - 11/29/2005BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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6iA www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER7 V APPLICATION DATE
Job Site Address �M0j 60" 10J LA-tJC Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name 6SME First Name eilm Middle DON�II�i(
Street Address 1) 1 LNE City State 40 Zip 2 `Q
CONTRACTOR INFO: Company Name t 1 Contraotd Phqnd# 22-6 -51 2-
Lic. Holder Name�11 .nA�,,IW �, n INA City of Fort Collins License # 6-19b Supervisor Cert # \v
Mailing Address_0155 bkk City eWO State LO Zip A05Z
LEGAL INFO:
Subdivision/PUD �4 Filing # I- Lot # � o Block # Lot Sq Ft jq 4VIOv
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 5Dd Total Garage Sq Ft �V
Residential Sq Ft Comm'I Sq
1 sc Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
# of Stories Bldg Height # Dwelling Units
_ Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft�
# of Full Baths 3/4 Baths '/z Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
5. Prescriptive w/Air Sealing
List appropriate option
# of Fireplaces
ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
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)
Contact Name & Phone # of JOBSITE SUPERVISOR: Kej)tJ 60FDZE R / 'L-63y
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Other
Applicant: I hereby acknowledge that I have read thi ication and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fortof ordinan d state laws regulating building construction. ��7
Applicant Signature Print Name Ktom 4PTk3e Phone 90?- S3y
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE