HomeMy WebLinkAbout1242 Camrose Ct - Applications/Addition or Alteration - 09/24/2010BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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www.fcgov.com/building
�ityofFort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER ` wG (O APPLICATION DATE OI l
Job Site Address 1 a` i -,), Cam,,, Ip-os C ' % Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone `#
Last Name �O�R C�} ��JZi First Name JA-AA(7--S �-114 &-QGIr Middle fF
Street Address I Q-,kA CEO ,%r ST— City F11-t LOLL I &JS State 60 Zip
CONTRACTOR INFO: Company Name Contractor Phone # 0 _ 2, b (D " R 9 C7
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
LEGAL INFO:
2 �a
Subdivision/PUD SA u T4 n'LAD (L VIt_t_Filing # 7—"' Lot # Block # Lot Sq Ft
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
1n Floor Sq Ft
2nd Floor Sq Ft
Unfinished Bsmt Sq Ft
Finished Bsmt Sq Ft
# of Bedrooms
# of Full Baths
% Baths Y Baths
# of Fireplaces
lir 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
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 . o D D
Description of Work: Sk ry 20 D wt Ac-1=, 0 t "I' 1 0 A4 /►r" t Z'2. A Sq. Cam- 'r , Pt-1 R Z P�-
Contact Name & Phone # of JOBSITE SUPERVISOR: 0 t td 0-I'm Q- '9 -70 - 2,.16- 99 1 0
Subcontractor Info: 'Sft�Q A y-Twc t+ ® Z 4 %-P, T-
Electrical
Framer
Roofing
Mechanical Plumbing
Concrete
Other
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.
%pplicant Signature C r TPrint Namea- M , F" t, W—H 1��Phone'970` 2 " 811 o
Distribution: White - Office Yellow - Applicant Pink - VWVW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE