HomeMy WebLinkAbout1015 Andrews Peak Dr - Applications/Multi Family New - 04/07/2005<.w 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 1,/ O 5 6 1 APPLICATION DATE LA -'I - M
Job Site Address \ (�\,ter c���4s����� Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # y42
Last Name' ,-� ��/� (J_ � {mot Name � Middle
Street Address '7;�yn_ City Y State_C _Zip�b
CONTRACTOR INFO: Company Name 3 X_f. D :7C:Lk*Nj,�� Contractor Phone # yq3-7�2�
Lic. Holder Name 57�' "i YX-_� City of Fort Collins License # C-A Supervisor Cert #
Mailing AddressyC'��`��r������' City. C pXi;nState_ Zip !6(),c�SLL
LEGAL INFO:
Subdivision/PUDS N; Qy ,� aDL �� Filing # Lot # Block #__V_ Lot Sq Ft`� �'
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft CIS
Residential Sq Ft Comm] Sq Ft # of Stories_ Bldg Height # Dwelling Units T
15t Floor Sq Ft 2^d Floor Sq Ft Unfinished Bsmt Sq Ft!aZDO!�) Finished Bsmt Sq Ft 4
# of Bedrooms 5 # of Full Baths 3/ Baths �— 'Y2 Baths �_ # of Fireplaces
Air Conditioning: Yes ISEnergy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealingia
,
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
is =�
Water Tap Size \i Sewer Tap Size — Metered: Esbr No Temp. Pedestal: Yes or No
Type of Heat: )(Gas ❑ Electric Electric Main Breaker Size (Residential only): X 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $
Description of Work: �(U _� ��t` -� �`�t y ��1. i� p��i a! c►�y�
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical T:1 MNU Mechanical Q moyxjA�e a Plumbing
Frame r n��� Roofing
[L��r-'� Concrete Other
7�T
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 NameAC_\X\ ° Phone
Distribution: Whi — Office Yellow —Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE