HomeMy WebLinkAbout3002 W Elizabeth St - Applications/Deck - 09/20/2005 (7)7NBUILDING PERMITS & INSPECTIONS DIVISION
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P.O. Box 580 • Fort Collins CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER "/ (J r?LI Ljq APPLICATION DATEA $
Job Site Address .3rn. IAJ ;,\Qe )K Unit # 3
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PROPERTY OWNER INFO: (All ow r infor ation is required - it is not optional) Phone # 2�% - C�/ R
Last Name �' ' First Name Middle
Street Address (4jn� State_4�Q_Zip �
CONTRACTOR INFO: Company Name Contractor Phone
Lic. Holder Name l76►±Li<<Y` City of Fort Collins License # �� (— 3L Supervisor Cert #
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Mailing Address , c� j t �� �� City h# (?A State l(T Zin r3 2
LEGAL INFO:
Subdivision/PUD b � E A i 0 ijo U) �; Filing #
CONSTRUCTION INFO, Total Building Sq Ft (not including basement) _
Residential Sq Ft Comm'I Sq
1 sc Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft
Lot # C Block # Lot Sq
Total Garage Sq Ft
# of Stories Bldg Height # Dwelling Units
- Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths % Baths 'Y2 Baths
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
# of Fireplaces
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
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) $ 7.
Contact Name & Phone # of JOBSITE SUPERVISOR:
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Electrical
Framer
Mechanical
Plumbing
Oth
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 Fo . ollins ord�ces an late laws regulating building construction.
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Applicant Signature •., Print Name �4% Phone 7.9t 2 3-3�j"S13
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
Roofing
Concrete
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE