HomeMy WebLinkAbout2554 Midpoint Dr - Applications/Addition or Alteration - 10/10/2007City of
I COMMUNITY DEVELOPMENT & NEIGHBORHOOD SERVICES
For t Collins 281 N. College Ave. a Fort Collins, CO 80522-0580 • Phone: 970-221-6760
www.fegov.com/building
(,rr�� BUILDING PERMIT APPLICATION
R APPLICATION NUMBER 1�V APPLICATION DATE
Job Site Address oZ55q
Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # cY70 X%1- 903
Last name—C 1yol r4 C.oC�t''t5 First Name Middle
Street Address- o BOK Soo City F t I r►'►S State C d Zip d -
/►
CONTRACTOR INFO Company Name LIt>}"Y ol: F-CoIleKS_ Contractor Phone
?# 970-AXI-6533
Lic Holder Name NrC-k Jeye-Ae(� 1 City of Fort Collins License # &ysJ Supervisor Cert # 3S Z 7" 1
Mailing Address 30(3 �ofie- Aur, ll �dq �� City FLCD (� "'kS State 60 Zip �bs2 j
LEGAL INFO:
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 7060 Total Garage Sq Ft
f
Residential Sq Ft Comm'I Sq Ft -7000 # of Stories_ Bldg Height 2-6 # Dwelling Units
1 s' Floor Sq Ft 7P90 2"d Floor Sq Ft
31d Floor Sq Ft
Unfiished Bsmt Sq Ft
Finished Bsmt Sq Ft # of Bedrooms # of Full Baths X % Baths Yz Baths # of Fireplaces
Air Conditioning Ye,V No 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 # List appropriate option
UTILITIES INFO:
Water Tap Size
Sewer Tap Size Metered Yes or
No Temp Pedestal Yes or
No
Type of Heat
pqGas
❑ Electric Electric Main Breaker Size (Residential only)
❑ 150 Amp or Less ;9�00 Amp
❑ Other
Value of Construction (including labor, material & profit) $ SI29i 01)y
Description of Work
Subcontractor Info:
Electrical Mechanical �ir C o 6-1 �pri'/^► Plumbing
Framer Roofing Concrete DS Fireplace
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 o ibis d/inanc�and state laws regulating building construction _ ?
Applicant Signature �- l / Print Name I V f`k jOVC'vin Phone P t , �`�/3
Distribution White -Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 180 DAYS FROM APPLICATION DATE