HomeMy WebLinkAbout4826 Prairie Vista Dr - Applications/Single Family New - 10/06/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
F6rtCollins 281 N. College Ave. - Fort Collins, CO 80522-0580 - Phone: 970-221-6760
www.fcgov.com/building
V
j � i � ' BUILDING PERMIT APPLICATION
APPLICATION NUMBER APPLICATION DATE (v `
Job Site Address -ygA(0 fKP,)Aie VIS-rA -bRIV6 Unit#
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 303- 311-- 9
Last name TRr-DONPAlf-w', 1kic iA"C' First Name Middle
Street Address 2 70 s-t `��t� c J7 gel 3DD City Dejoy>tr 1_— State Cio zip boDo �
CONTRACTOR INFO: Company Name ISA K 1' n.6fs12y aE l/-0NS7. Contractor Phone # �i � � t5 Wp — 057 J
Lic Holder Name 3to$ tri' llas City of Fort Collins. License # Supervisor Cert #
Mailing Address 3gaato S o.+►'t ML°o"�xtY `iZotm / r/ City . L6V6,_0riJD -::: -.ate C.'7 zip g053 `7
LEGAL INFO:
Subdivision/PUD I�A-P-MJOP'Y
CONSTRUCTION INFO: Total Building Sq Ft (not including
Residential Sq Ft Comm'I Sq Ft.
# _Lot # Block # Lot Sq Ft T 7.>D
, 7 �i Total Garage Sq Ft atl7
Stories__,A,,Bldg"9;;ight ;LZO # Dwelling Units
1 s' Floor Sq Ft 9 96 2nd Floor Sq Ft 14 (P 31d Floor Sq Ft
Unfiished Bsmt Sq Ft 9 -1
Finished Bsmt Sq Ft -Q- # of Bedrooms A # of Full Baths 9% % Baths '/2 Baths I # of Fireplaces I
Air Conditioning: IS
No Energy info: ( Circle appropriate choice ) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door Oimulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
It 1 f
Water Tap Size 3%4- Sewer Tap Size t�'
Metere Ye,,4 or
No Temp. Pedest Yes r
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) $_r ' Q ti
Description of Work: rie w S % t0C>-t G 1=Rrtnn y 'DE —>'A N� /1 1Z E5
Contact Name & Phone # of JOBSITE SUPERVISOR: rJ012s '•% awl kt as q -7O — `J (6 fo — OS 7 A
Subcontractor Info:
Electrical_ �G'12 �-K L �►-L'C-i. Mechanical �DN't`1`S 476,. AM(L- Plumbing SGD,7n7-_l'K�E T4&�Z.
Framer C� '( MotiLC %. Roofing &)Lb 0�W> Concrete rRZJ Fireplace'Y�/�TC=*43 %REPukC€
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 ordinances and state laws regulating building construction.
Applicant SignatureY72�11��rint Namej�OB J�E t &OS Phone q?O -ski , 05
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE