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HomeMy WebLinkAbout118 S WHITCOMB ST - APPLICATIONS - 3/23/2007BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building 1019 City of Fort Collins BUILDING PERMIT APPLICATION lag,3Z APPLICATION NUMBER O� 7c;Lo APPLICATION DATE Job Site Address Unit # PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # q-1 b- 9 aG_ (v 3q. Last Name K0.\a First Name L ,%r--_ ' Middle Street Address 1\`l3 S.City Vac -'IC CokkkNs State Ca zip$6Si�(n CONTRACTOR INFO: Company Name Contractor Phone # Lic. Holder Name City of Fort Collins License # Supervisor Cert # Mailing AddressQ C 0 iys City�'V&_ca-v-kC-L- State Czip $Q'5%':o LEGAL INFO: Subdivision/PUD Filing # Lot # N VI -I Block # -LA__ Lot Sq Ft 61 $66 CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft Residential Sq Ft t�lsg Comm'I Sq Ft # of Stories Bldg Height #Dwelling Units 1st Floor Sq Ft /D SS 2cd Floor Sq Ft 90c9 Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft _ # of Bedrooms Lf # of Full Baths c. 3/4 Baths k '/2 Baths # of Fireplaces Air Conditioning: Yes (�D Energy info: (Circle appropriate choice) 1. ComCheck 3. ResCheck w/Blower Door 4.' E-Star w/Blower Door 5. Prescriptive w/Air Sealing City of Fort Collins Stock Plan # UTILITIES INFO: List appropriate option 2. ResCheck w/Air Sealing 6. Prescriptive w/Blower Door Water Tap Size Sewer Tap Size 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) $r �� 0 e;) Description Ic Ic Contact Name & Phone # of JOBSITE SUPERVISOR: !� / LjvfLm Subcontractor Info: Electrical L��beS �C�a Mechanical Plumbing RQtM Framer K 0.�l'_u Roofing Concrete 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 gf Fort Collins ordinances and state laws regulating building construction. Applicant Signatur Print Name Laan e— Phone 4wO' G :19%tA Distribution: MAO — Office Yellow — Applicant Pink — WWW/Star a er THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE