HomeMy WebLinkAbout6802 NIMITZ DR - APPLICATIONS - 11/19/2008 (2)BUILDING PERMITS & INSPECTIONS DIVISION
s P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
CityofFort Collin s BUILDING PERMIT APPLICATION
APPLICATION NUMBER -'✓ 'YO lAPPLICATION DATE
Job Site Address -(, Q& (1,m'%N2 (�f (-1\ ck 19 Unit # e Iof- 1OH
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # ,03 - A40dy -,a'4 (a
Last Name COolk2 First Name �-MA Middle
Street Address k\$Sy &U'A City State-co_Zip �SQ�31
CONTRACTOR INFO: Company Name & 'Onno pa5+r d-[..n Contractor Phone # -Zqf R
Lic. Holder Name ';rc.c� e0olte_ City of Fort Collins License # 2 - /b 9 Supervisor Cert # Z 7SS �CoZ
Mailing Address k\115S!q 60-,.Aburl'\ city (,1. r'+Mj'Q5 State G.C) Zip ?on'3I
LEGAL INFO:
Subdivision/PUD��g� �' Q�� n Q _ Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) (aLf _ill Total Garage Sq Ft
Residential Sq Ft (0 9 k? Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft 2nd Floor Sq Ft �� Unfinished Bsmt Sq FtSao( Finished Bsmt Sq Ft
# of Bedrooms 1 d # of Full Baths % Baths '/2 Baths --2 # 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 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan # I -1to (o List appropriate option #s
UTILITIES INFO:
t 'I `'
Water Tap Size ��, Sewer Tap Size � Metered: Yes or No Temp. Pedestal: es or No
Type of Heat: VGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ (x6S 1(.L'I
Description of Work: {1 P�,_� Ccxv-'4-tt CA, �. on mv"t \ - -fin � C -16..1;-,s +_ 1-4
Contact Name & Phone # of JOBSITE SUPERVISOR: �r ur1 nn� -.- 30--i- H 7 H (a b
Subcontractor Info:
Electrical'SkMT�5f,r\ t'-� �t Mechanical 6 2 - "' n . Plumbing
Framer tr-o\G CY &x-y\ inc Roofing NA :Cy\c- Concrete '5r)o(, 5 fiaXy k- 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 54 Collins/rdinances a O state laws regulating building construction.
Applicant Signature Print Name 1 e-*,e—K (,e U Phone q'70
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THS APPi°iCATOH EXPORES 90 DAYS FROM APPUCATVON DATE