HomeMy WebLinkAbout621 Stonington Ln - Applications/Deck - 06/25/2005BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.f cgov.com/building
City of Fort Collins BUILDING PERMIT APPLI TION
APPLICATION NUMBER� [ I APPLICATION DATE
Job Site Address k2 t '5�rQ1j1 wc-I oL► Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not Dc
ot optional) Phone # 193 ��Q
Last Name 00 /
0y First Name f I 1 A -eV 5 -rb Middle Street Address City }'T . Ccx.4-( N State cCO Zip WC&qq
CONTRACTOR INFO:: Company Name Contractor Phone #
Lic. Holder Name City of Fort Collins License # AM St Supervisor Cert #
Mailing Address 441-1 %, 1) 5- r V l • City W ( I v NSo e State Zip p 0s-!Z
LEGAL INFO: nn , t
Subdivision/PUD 1�106�D --t-'C1cc.S Filing # J2"— Lot # Block # Lot Sq
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
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 Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _
# of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option
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) $ o i d ct?
Description of
Contact Name & Phone # of JOBSITE SUPERVISOR: (2M6 VlK)GLC-qC1) 691 TSSO
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Other
Applicant: I hereby acknowledge that I have ad this application and state that the above information is correct and agree to comply with all requirements
contained herein and City of Fort s ordi c s and state laws regulating building construction. , ` L
Applicant Signature Print Name�C �6 df 06Phone
Dis bution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE