HomeMy WebLinkAbout420 HUDSON CT - APPLICATIONS - 3/4/2009BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
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www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER w O I z� I APPLICATION DATE I art 04'- anon
Job Site Address I19Q JyAdSnV) C t Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name Fba 1 o na First Name T Vim, Middle
Street Address j LOS) t City FD V C011t ns Stater'o Zip
CONTRACTOR INFO: Company Name
Contractor Phone #
Lic. Holder Name City of Fort Collins License #
Mailing Address City
LEGAL INFO:
Supervisor Cert #.
State Zip
Subdivision/PUD2d e, 10� I I I � �D u Filing #_� Lot #� Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st 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 Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft 3 � 5
# of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size
List appropriate option #s
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) $50� �t
Description of Work: Y11sh -RaSemey\t , ,l_ y n I fj) g eG Ipn w a y\J ?�CayDo m lc ErC e'
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
Other
Applicant: I hereby ackno ledge 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 f Fort Collin ordinaricejand s to laws regulating building construction. p
Applicant Signat Print Name Phone 9'1 0 "1l6'd310_
istri do W ite — Office Yellow — Applicant Pink — W /Stormwa
THIS A CAT N EXPIRES 90 DAYS FROM APPLICATION DATE