HomeMy WebLinkAbout4721 PRAIRIE VISTA DR - APPLICATIONS - 3/22/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.conVbuilding
BUILDING PERMIT APPLICATION
APPLICATION NUMBER f3 W if `s Iq APPLICATION DATE 31 a 2XI DI I
Job Site Address
.PJ Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not
not optional) Phone # �(
Last Name IS LLB First Name /W' 640r" �b,4— Middle /�'
Street Address 3lv(5 ,r✓(,/¢-c�r./G , 1�city � � il07 StateC� Zip
CONTRACTOR INFO: CompanyName Tl r A � �F/�yf� contractor Phone # 56oe %
Lic. Holder Name R��e- ��S 1e%%rfYr-- City of Fort Collins Licensee # I� 0 Supervisor Cert #
Mailing Address i9 4 0. e4 -R4 S = K4 City 41: ' �I1(1 State Zip
LEGAL INFO:
Subdivision/PUD HO ytN+gnL( 121 ^"� Filing # Lot # Block # — Lot Sq Ft r
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) 7'; Total Garage Sq Ft
Residential Sq Ft1 Comm'l Sq Ft # of Stories_ Bldg Height C Q # Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft 'VL-� Finished Bsmt Sq Ft f�
# of Bedrooms 14 # of Full Baths 1/4 Baths �_ '/2 Baths # of Fireplaces
Air Conditioning: es No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door i0rescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
List appropriate option
UTILITIES INFO:
Water Tap Size ttt Sewer Tap Size Metered: (5)or No Temp. Pedestal Yes or No
pp Type of Heat: Gas ❑ Electric Electric Main Breaker Size (Residential only): /X150 Amp or Less ❑ 200 Amp ❑ Other
Value of'Construction (including labor, material & profit) $ a� 1.1 9 09, (0io
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical �LC.�Aj11),,% Mechanical fl-A I>' Plumbing /�. r A4 17
Framer ,(� iA-!L Roofing W � Concrete k�PI --I^, Other �iCti'eS TEU�
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 C Fort fines ordinances and state laws regulating building construction.
Applicant Applicant Signature ,• ((�.��-�iL Print Name �fi%Mt Phone' %�`Jr
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater F4X ZZi - 51-56
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE