HomeMy WebLinkAbout713 Cherokee Dr - Applications/Addition or Alteration - 06/23/2006�S BUILDING 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 rP APPLICATION DATE
Job Site Address Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # all
Last Name Zip k First Name A �__ c*." aI/ Middle
Street Address 7/3 Cieccg ke /9-4,c CitState Cc.--) Zip &:LS.2-'q�
CONTRACTOR INFO: Company Name N4iL.,- LLe Contractor Phone # (97c?)
Lic. Holder Name /Q.Gi%�� /�l�a,��-i o q City of Fort Collins License # d? -.3S !F Supervisor Cert # 23!�!j
Mailing Address /40 2 72":5' City ���` Cm.+d:il,S State Gy Zip 8nS 2 >
LEGAL INFO: pp
Subdivision/PUD •=nrXian id, ws Filing # Lot # Block #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft # c
1st Floor Sq Ft
Lot Sq Ft
Total Garage Sq Ft
)f Stories Bldg Height # Dwelling Units
Sq'
Unfinished Bsmt Sq Ft� Finished Bsmt Sq Ft `
# of Bedrooms # of Full Baths '/, Baths '/2 Baths # of Fireplaces V
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
Type of Heat: ❑ Gas ❑ Electric
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower DoorI.
List appropriate option #s
Metered: Yes or No Temp. Pedestal: Yes or No
Electric Main Breaker Size (Residential only) : 50 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
of
1. r
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical rA Mechanical 7-4 (,) Plumbing r/3 D
Framer T,g O Roofing nfin Concrete 72D 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 Print Name ofe,�k Phone i�2o -s�z
Distribution: White — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE