HomeMy WebLinkAbout2009 Mesaview Ln - Applications/Deck - 10/02/2012City of
�,.Fort Collins
APPLICATION
COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION
Job Site Address Z06,9 LK Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # Z ZS 6c) 6
Last name C "r pig a-d First Name // Middle
Street Address Zlgvq %M�`3/�i L`�w L, City /Fnv-t C�,Ilt t State �u Zip
CONTRACTOR INFO: Company Name � i�Lr yf Contractor Phone #
Lic Holder Name Re e GL OP Lc City of Fort Collins Licensee # Supervisor Cert #
Mailing Address t� �%2 1 JI�GG��m" �/ !7 j 11 City (� !/i-�il�l Q State Zip e SZ
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft_
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units _
1s' Floor Sq Ft 2nd Floor Sq Ft 3'd Floor Sq Ft Unfiished Bsmt Sq Ft _
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths '/4 Baths /2 Baths # of Fireplaces
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
List appropriate option #s
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: ( 20 Sd E'
Contact Name & Phone # of JOBSITE SUPERVISOR: CG 17 c' ��L- LS 5 ¢ fd l y
Subcontractor Info:
Electrical
Framer
Solar
Roofing
Other
Mechanical
Concrete
Other
Plumbing
Fireplace
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. Q
Applicant Signature Print Name ( e r % GI G, Phone ( /
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE