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HomeMy WebLinkAbout5236 Clarendon Hills Dr - Applications/Single Family New - 01/08/2010BUILDING PERMITS & INSPECTIONS DMSION PO Box 580 FortCollets CO 80522.0.580 Phone 221-6760 www fcgov com/b"ding CttyofFortColluts BUILDING PERMIT APPLICATION APPLICATION NUMBER 151 01 J 0 1 0"J APPLICATION DATE d L I ©O I a 0 10 Job Site Address 5�23& 0/1 Unit # . / ./ Phone # :$ .S - ,9.37 -, W-2 J' (AII owner information is required - it is not optional) Last Name First Name -,r0d-A1 Middle Street Address__ /O// P►� LialfB G� City �TiG[ t✓MfTsJe State��Zip CONTRACTOR INFO Company Name 64c,,10,6 l _ �n/ta� _ _ Contractor Phone # 92V - ? 2� -- ,24Y Lic Holder Name �7Gln/f17UFA,r,/�C[ Ay,&Ar5* City of Fort Collins License #c1-19 Supervisor Cert # Mailing Addressslo�IIr� ll 1T� City. State GQ Zjp LEGALINFO Subdiwsion/PUD Filing #�f C /I% Lot #___Y_ Block # Lot Sq Ft- 7.L CONSTRUCTION INFO Total Budding Sq Ft (not nd d ng baeeme t) Total Garage Sq Ft Residential Sq Ft c�A _ Comm I Sq Ft # of Stones_ Bldg Height a?'.Ir # Dwelling Units 1u Floor Sq Ft O�7 ' 4 2nd Floor Sq Ft # of Bedrooms # of Full Baths r R Air Condkioning es No Energy info (Circle appro 3 ResCheck w/Blower Door 4 E Star w/Blower Door City of Fort Collins Stock Plan # Unfinished Bsmt Sq Ft (g Finished Bsmt Sq Ft "�-- / Baths '""�- / Baths # of Fireplaces date choice) 1 ComCheck 2 ResChe w/AirSealing 5 Prescriptive w/Air Sealing 6 Prescriptive w/Blower Door List appropriate option U TI mES INED N N Water Tap Size 3 � Sewer Tap Size �- Metered Yes r No Temp Pedestal � or No Type of Heat Oi as ❑ Electric Electric Main Breaker Size (Residential only) ❑ 150 Amp or Less Amp ❑ Other Value of Construction (including labor material & profit) E �� 00co7 00', r T— Q,/�� escnpbon of Work �J �iJ rho [►E ��+w� c. Y �Q'- /�4t_ f�Oi %�t Q . r I _ irc AVP.e. -.e, r7 L. c.1 on Contact Name & Phone # of JOBSITE SUPERVISOR / s vA4-, S S7 .17� Subcontractor Info. r 397 Electrical �I fGt`/ LZG Mechanical / Plumbing �rJ�/aG✓t fr<� Framer f�+P s Roofing 707�n 11L?./�!n,�1 Concrete �� Other Applicant I hereby adinowledge that I have read this application and state that the above information is correct and to comply with all requirements contained herein and City of Fort C llms ordinances and state laws regulating building nst ructio n /?� Applicant Signatu Print Name�r.I?1�4i,✓ Chone 7Tl/ i/Ti Distribution White - Office Yellow - Applicant Pink - WW W/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE