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Home My WebLink About4006 Big Dipper Dr - Applications/Single Family New - 09/26/2011BUILDING PERMITS 8L INSPECTIONS DIVISION P.O. Box 580 •Fort Collins, CO 80522r0580 • Phone: 221-6760 www.fcgov.com/building 6Z City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBER 1 1" O APPLICATION DATE �jA0I ( Job Site Address A4 C' RIQ ai >,pp=a !;6.P; V'P_ Unit # PROPERTY OWNER INFO: (All owner information is required -it is not optional) Phone # 07 _0 73 9 Last Name NJ+C'% Z Scan. First Name & IC_ Middle Street Address oG IL cy Let� -e.Z_ City 045.7 6i /�d S n State Zip 8�. CONTRACTOR INFO: Company Name GA,'�� Yyti��y ontractor Phone # 1 I©'S 1710 Lic. Holder Name \,)nj u- �>A. VLty 0"\ City of Fort Collins License # Supervisor Cert #t?463- J�j 1 Mailing Address -�'Z ilvy II'J� City tvW NAr e_ State Cm Zip Af.u%36` LEGAL INFO: Subdivision/PUD CIO OAK > Filing # - Lot # ( Block # - Lot Sq Ft `, CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft 3L9 Comm] Sq Ft # of Stories 2 Bldg Height # Dwelling Units I 1st Floor Sq Ft d.6� 2nd Floor Sq Ft 7� L Unfinished Bsmt Sq Ft 10a 3 Finished Bsmt Sq Ft g # of Bedrooms -3 # of Full Baths Baths '/z Baths 2 # of Fireplaces I Air Conditioning: 6D No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing 3. ResCheck w/Blower Door 4� w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door City of Fort Collins Stock Plan # List appropriate option #s UTILITIES INFO: 4 Water Tap Size 31y Sewer Tap Size Metered: 0e or No Temp. Pedestal: Y�e or No Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less jN 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ Z-74" 000.vJ Description of Work: titl , I oil a (; G U c a- LIS) 1'k �- �+ S P t Yw✓� a— A,\S CV-ALJ� SaAce— Contact Name & Phone # of JOBSITE SUPERVISOR: C 1e.,, 7 0 Subcontractor Info: Electrical 0 JeA Ire iC ,F?7/e-dY- t` Mechanical 3Ooc4Gy to kt ti U` Plumbing Lo lc �(U�ta b t%k4 I1,r (� t FramerL, n<1 G7�wl�Qk*oofing Gt9-r' Qooyv�nr� Concrete (-�cC_5CAmCr A!eA �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 F,4 Collins ordinances and state laws regulating building construction. Applicant Signature (,4-� / Print Name LQ_ GAr'cIn!!�1 Phone M0 Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE