HomeMy WebLinkAbout956 NIGHTINGALE DR - APPLICATIONS - 3/20/2009/3 6 /
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
65
APPLICATION NUMBER 6' / l "
RAPPLICATION DATE 0
Job Site Address
Unit #
PROPERTY OWNER INFO: (All owner inf a ation is quired - it is not optio al) Phone # M
Last Name First Name / , e Middle
Street Address City /�/��4 f State�ZipKdocwr
CONTRACTOR INFO: Company Name ��/��rC Contractor Phone #
Lic. Holder Name City of Fort Collins License # ,--,
Mailing Address City/r/%/%S State -
LEGAL INFO:
Subdivision/PUD Filing # L t # Block #
CONSTRUCTION IN Total Building Sq Ft (not including basement) Total Gara
Supervisor Cert #
' I �' I
)Lot Sq Fr-4-5
f\1`
Ft
Residential Sq Ft Comm'I Sq Ft # of Stories_ B #Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft_Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 6 Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option #s
!/
Water Tap Size Sewer Tap Size Metered: Yes r No Temp. Pedestal: Ye or No
Type of Heat: Gas ❑Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less j)4 200 Amp ❑ Other
Contact Name & Phone # of JOBSITE SUPERVISOR:
cc Z,
Subcontractor Info: v
l / �
Electrical Mechanical Plumbing ,/�lyJ�
Framer A4 Ul&JRoofing L Concrete - - lC Other
Applicant: I hereby acknowled a that I have read tWW s plication and state that the above information is correct and agree to comply with all requirements
contained herein and City of Collins ordinang and state aws regulating building construction.
Applicant Signature Print Name Phone
Distribution: White — Office Yellow — Applica Pink — WWW/Stormwater
THIS APPLICATION (EXPIRES 90 DAYS FROM APPLICATION DATE