HomeMy WebLinkAbout1922 Raven View Rd - Applications/Single Family New - 12/20/2011City of COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
Fort Collins 281 N. College Ave. • Fort Collins, CO 80522-0580 • Phone: 970-221-6760
/ "� www.fcgovcom/building
BUILDING PERMIT APPLICATION
APPLICATION NUMBER ) I I 1 l APPLICATION DATE 1)`/ate l k. 1
Job Site Address IV,2 enli/Pw Ut w h'ga_ , PoSZ / Unit #
Last
(All owner information is required - it is not optional) Phone #.
First
Middle
Street Address �ra/rTO�� City ��• b/�f1� Sttaatttee���Zip d u
CONTRACTOR INFO: Company Name o,%%C i0,,- t/ e 4 Contractor Phone # 0jlr_gp �
Lic Holder Name teLSC_S City of Fort Collins�License # C�� Supervisor Cart # 7yS—eez
Mailing Address 27.r� LS j� IZ�,�C/J� City � 61&JA State Zip Pz7f
LEGAL INFO:
Subdivision/PUD ton (11? Filing # Lot # -V Block # Lot Sq Ft 111,197
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) !C'I�Vn Total Garage Sq Ft /Zya
Residential Sq Ft ��w Comm'I Sq Ft O # of Stories .2 Bldg Height o2.5'- # Dwelling Units
151 Floor Sq Ft S %w 2nd Floor Sq Ft S772 31d Floor Sq Ft Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft O # of Bedrooms 2 - # of Full Baths % Baths / % Baths _/ # of Fireplaces 0
Air Conditioning: Yes 0 Energy info:( Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. Simulated Performance Alternative 5. Prescriptive w/Air Sealing 6. Prescriptive w/ Blower Door
City of Fort Collins Stock Plan # 1-7G 3 List appropriate option #s
UTILITIES INFO:
Water Tap Size f Sewer Tap Size Metered: Yes o No Temp. Pedestal Or No
Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only) A150 Amp or Less ❑ 2200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ z� /J `�,(�, /� za6, A& el
Description of Work: /l/4d S!n�zlO '_441r 1Ly Qi 6lG�Gd T�wi'�GIOiY1L°
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: / f
Electrical ,9` Aeyvrd' Mechanical V /� /' Q101 t Plumbing Xye'-e-n ale
Framer Roofing Concrete VGZ6Fireplace
Solar Other Other Other
)Applicant: I hereby acknowledge that I have r this application and state that the above information is correct and agree to comply with all requirements
.,. contained herein and City of Fort Collins r ' nces and state laws regulating building construction.
Applicant Signature Print Name Rl UvL' Phone l`1 gam
.Distribution: White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE