HomeMy WebLinkAbout2633 Pleasant Valley Rd - Applications/Deck - 05/26/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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City of Fort Collins BUILDING PERMIT APPLICATION
a� APPLICATION NUMBER 0n) 1DAPPLICATION DATE
Job Site Address 2A33 pI ea -SA In-' VC4 0 eU RA Unit # / ,�
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # T %Q - 22 1 '-g360
Last Name tAw r S to S h 1t fia First Name , ` I u 1= Q ` k h l KV Middle
Street Address � 633 P kowwrr VQ N e y KGA . City ;Fo r i C t7 II `cVt5 State � o Zip 905a l
CONTRACTOR INFO: Company Name &beVe IUc3trS cov%SI'N4116111 Contractor Phone #
Lic. Holder Name S t'ayp- l.p ed"S City of Fort Collins L3 License # F 3 Supervisor Cert #
Mailing Address A6 26 P 1 �� SG��tr1/� i! ey e • City gFOr-r Co 1 k 'q S State CCU Zip 905.7- l
LEGAL INFO:
Subdivision/PUD
Filing # Lot #
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Block # Lot Sq Ft 6 0 1
Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2^d Floor Sq Ft
Unfinished Bsmt Sq Ft.
# of Full Baths % Baths '/2 Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option #s.
Finished Bsmt Sq Ft
# of Fireplaces
2. ResCheck w/Air Sealing
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) $ a'Oko
Description of Work: jet K £ 1, J d e-k 0 rn '-t-VL e
S 2f' Cl i'"t"a c d e! C2 / a n cLt l- f0)24 .L -
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 City
ro�f�Fort Collins ordinances and state laws regulating building construction.
Cleo KkrSLL-5k1+q'
Applicant Signature Print Name-114.5kiKesi 1az'C"si,tSilI-M Phone 970--221- 93�0
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE