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HomeMy WebLinkAbout4720 Prairie Vista Dr - Applications/Single Family New - 10/08/2010i OW K Y F6rt Cityof COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760 www.fcgov.com/building BUILDING PERMIT APPLICATION APPLICATION NUMBER -51(DO lQ 44- APPLICATION DATE /0 — TS - fD Job Site Address V P,,?O �2 A-1 9 t�. Vts-rA 0kil c%@ Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # _�?03 % 7 /9 V / Last name P K A N 16R 1b First Name>EA) N 15 Middle Street Address 6 Gy / /l(r / i 49" 461-a City State Co Zip X0 `/ CONTRACTOR INFO: Company Name &I / GA �d-jLU.c ice/ Contractor Phone # %? 0 /, 7,-:;�- O O Fs Lic Holder Name D�t% 1 L`� s/il /% �� City of Fort Collins License # 8 -5400 Supervisor Cert # 1099 Mailing Address NZ1 1113 S Pgue, -I City , C .. --State C'0 Zip 9105-A 5� LEGAL INFO: r- FtSubdivision/PUD I1� R �76,� y �ZI h 6E Filing # Lot Blo k # Lot S _ CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 7 Total Garage Sq Ft Residential Sq Ft Comm'I Sq Ft # of Stories_ Bldg Height .27 — # Dwelling Units 111 Floor Sq Ft %y`� 2nd Floor Sq Ft 3m Floor Sq Ft Unfiished Bsmt Sq Ft 137 ,/ J Finished Bsmt Sq Ft 13 y/- # of Bedrooms # of Full Baths I— -/, Baths _j_ '/2 Baths _�_ # of Fireplaces /-) © Air Conditioning: es No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing INI 3. ResCheck w/Blower Door 4. Simulate ce Alternative S. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door City of Fort Collins Stock Plan # List appropriate option #s UTILITIES INFO: Water Tap Size Sewer Tap Size Metered.0Yes orNo Temp. Pede tal Yes r No Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only) N 50 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ V oU Description of Work: Ae tj S. A p �e F-ea-" ,.,:t„ H o *-.e 01 Contact Name & Phone # of JOBSITE SUPERVISOR: DAJ d -s Subcontractor Info: nn�� Electrical AL /Z Mechanical /rt���� 1Vt0—(J1-kW/0 Plumbing L4c.,ce -le$e Framer CP_ TA- Roofing // �cd� f �;l}Concrete e.r!'i� Phi Fireplace !✓y Solar Other Other 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 ordin es and state laws regulating building construction. c� Applicant Signature Print Name U� ��i.I�.DS Phone%Q - Di57 Distribution: White - Office Yellow - Applicant Pink - WW/Stormwater THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE