HomeMy WebLinkAbout645 REMINGTON ST - APPLICATIONS - 1/5/2007BUILDING PERMITS & INSPECTIONS DIVISION
j 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 O - APP>ION DATEi—
Job Site Address 40 1 - q.' 90h I IV GTO Ar Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name
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First Name
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Middle E7-•
Street Address
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City
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CONTRACTOR INFO: Company Name
Lic. Holder
Contractor Phone #
City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
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Subdivision/PUD Filing # Lot Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 3 3 3 y Total Garage Sq Ft -3 (.0 O
TO (' O lb,
Residential Sq Ft -3j I Comm'I Sq Ft # of Stories "L__ Bldg Height # Dwelling Units -L
1st Floor Sq Ft i G 2nd Floor Sq Ft O Unfinished Bsmt Sq Ft n Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths _ 1/4 Baths n /2 Baths 0 # of Fireplaces
Air Conditioning: Yes 0 Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing VV
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
4. E-Star w/Blower Door
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
UTILITIES INFO:
Water Tap Size Sewer Tap Size Metered: es or No Temp. Pedestal: Yes or No
Type of Heat: X Gas ❑ Electric Electric Main Breaker Size (Residential only): X 150 Amp or Less ❑ 200 Amp ❑ Other 1
Value of Construction (including labor, material & profit)
Description
Contact Name & Phone # of JOBOTE SUPERVISOR -
Subcontractor Info: / r)
Electrical Mechanical
Framer
Roofing
Concrete
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_Fort Collins ordinances and state laws regulating building constructions.. G C,
Applicant Signature Print Name ,' [' _ LIAN Il rl��% Phone
Distribution: White - Offi e Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE