HomeMy WebLinkAbout4732 Regency Dr - Applications/Patio Cover Or Sun Shade - 08/09/2010BUILDING 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 G �/, �c� APPLICATION DATE g"Ig/!y
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name -1� a--e pySn lc�' First Name "k cox `i- a y� Middle -'esz
Street Address !V F=g� i a Q� rcyR- City �,r-� 1� lr\S State C� -Zip b
CONTRACTOR INFO: Company Name Ar--,Win 5L4eN�Orl t ontractor Phone
Lie. Holder Name -Y�Sq �12-64 1c, City of Fort Collins License #- q 7:7- _ Supervisor Cert # SoLAy-DI
Mailing Address 901 1,]XACI f CitState (.n Zips i u
LEGAL INFO: )
Subdivision/PUD- 2{�T�a e.- D /O� 1 Filing # & 4 & Lot #-q6 Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft 44
Residential Sq Ft /S3� Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft /5� �y 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms -3 # of Full Baths '/4 Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing t
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Water Tap Size Sewer Tap Size Metered: �or No Temp. Pedestal: Yes or No
Type of Heat: XGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less X200 Amp ❑ Other
Value of Construction (including labor, material &'profit) $ /d 1005
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical Mechanical Plumbingi/i¢
/1
Framer '',b l d„�5 �,r„�_ Roofing Concrete Otvhe�r
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 Signatu
Print Name
Phone
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE