HomeMy WebLinkAbout618 Ponderosa Dr - Applications/Addition or Alteration - 03/18/2010BUILDING PERMITS & INSPECTIONS DIVISION
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PO Box 580 FortCollins CO 80522r0580 Phone 2216760
www fcgov com/building ✓
C,tyofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER (U V 1;541+' APPLICATION DATE `6 /Y /y
Job Site Address 6 (- Pot jJGMS ok [)F,-- Unnitt#
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PROPERTY OWNER INFO (All owner information is required - it is not optional) Phone # Q —Qaa--7a 3 k
Last Name dN First Name ::Dl%x?�-/,�/ L Middle
Street Address Q�_ e cfl- L-2 e- City C2-I I��Tu/l/ State C d Zlp�
CONTRACTOR INFO Company Name � � 4%Dntractor Phone # 9%0 -aa� -rf 17 Z
Lic Holder Name y�g �`��iein/ City of Fort Collins License # .Supervisor Cart #
Mailing Address J J �� 62 [`� City PW4k5J4uAjState W Zip
LEGAL INFO
Subdivision/PUD Filing # Lot #_
CONSTRUCTION INFO Total Building Sq Ft t t I d g b m Q
Block # Lot Sq Ft_
Total Garage Sq Ft
Residential Sq Ft Comm I Sq Ft # of Stories Bldg Height # Dwelling Units
1 t Floor Sq Ft
# of Bedrooms
Air Condthoning Yes No
3 ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO
2 d Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths / Baths / 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 11200 Amp ❑ Other
Value of Construction (including labor material & profit) $
�d' Description of Work `Kb'f- F A oA (i k< [
5�-2 3 !AAA. L=70-e'rr I win / /i
Contact Name & Phone # of JOBSITE SUPERVISOR
Subcontractor Info
Electrical4-If Mechanical
Framer
Roofing
Concrete
Plumbing Ly v 1��
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 Name Phone
Distribution White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE