HomeMy WebLinkAbout3626 Little Dipper Dr - Applications/Single Family New - 04/14/2011B1 101496,
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fCOIWIV ""ITY DEVELOPMENT' & NEIGHBORHOOD SERVICES
F-81 Co ns 281 N. College Ave. • Fort Collins; CO 80524 • Phone: 970-416-2740
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ww fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE
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Job Site Address[1oTor /mil V!�- Unit # /
PROPERTY QW19�11)NEO: (All owne nfor a 'requiired - isynot
�optional) Phone # �(�� ' ��� ` �3 7
Last name' " "" ' i 4&4 " ` ��`fsi s�ll�arpfe�y// ILS Middle
Street AddressyAO Qr iGf dCl/l.�Q�� City �T�%°�I/GGY� U,State_CZ_Zi Q //
CONTRACTOR INFO:
-Company
�Name Contractor Phone # Lic Holder Name /(��%'% l V�//i City of Fort Collins License Supervisor Cert # Q -, n
Mailing Address City State Zip
LEGAL INFO:
Subdivision/PUB ! �//�/-�bl'C12 Filing # Lot # i 3D Block # Lot Sq Ft, Zoo
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) ! Total Garage Sq Ft 4& 7'
r •r
Residential Sq Ft rI Comm'I Sq Ft # of Stories Bldg Height 23-% # Dwelling Units
111 Floor Sq Ft 2nd Floor Sq Ft �- 3rd Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft _�� # of Bedrooms _?.— # of Full Baths -?,— s/. Baths '/2 Baths # of Fireplaces
Air Conditioning: Ye to Energy info: ( Circle appropriate choice) 1. ComCheck a 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door a4. Simulated Performance Alternative�Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Doom
City of Fort Collins Stock Plan # List appropriate option #s 2
UTILITIES INFO:
Water Tap Size 3/y p Sewer Tap Size 410 Metered: Yes [�]`No[] Temp. Pedestal YesDNo F
Type of Neat: Gas Electric Electric Main Breaker Size (Residential only) 2150 Amp or Less 11 200 Amp: "❑Other
Value of Construction (including labor, material & profit)
Description of
cLx ul
Contact Name 8 Phone # of JOBSITE SUPERVISOR: raW &ZV 17 303 - Y1:f
Subcontractor Info: /,� / . J�
Electrica`l.67YI G I�U�! lt! ��( /Mechaniical,�Q�S�T�5fJGfP_ /4s�/1 /f�1� /!Plum' Plumbing.
b/Im
Framer VP�k A � obfing (- f/h� &JI �arAoncrete L✓CJ�1 Q A. (�/fIJCJ�eplace
Solar
Other
Other
Other
Applicant: I hereby acknowledge that I v read th plication and state that the above information is correct and agree to comply with all requirements
contained herein and City of F rt C inan n ate laws regulating building construction. / /
Applicant Signature Print Name A&I. �1745yrar PhoneW - 7.43 A 73`j
Distribution: White - Office Yellow - Applicant Pink-1MMN/Stonnwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE