HomeMy WebLinkAbout4307 MILL CREEK CT - APPLICATIONS - 5/17/2007BUILDING PERMITS & INSPECTIONS DIVISION
090 P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
im www.fcgov.com/building
City of Fort Coll ins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �D APPLICATION DATE �- �e7
pop bite Address &OU' I 01-U. (,{LEC-X C 4 Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not
optional) Phone
Last Name SFMi N� MJ��Z First Name ►�YNE7irn►E Middle MFbu-r,
Street Address 30�% /YI�L GZ�( T City_ iL12T COD-W3 State_CD_Zip
CONTRACTOR INFO: Company Name Contractor Phone
Lic. Holder Name City of Fort Collins License # Supervisor Cart #
Mailing Address City. State Zip
LEGAL INFO•
Subdivision/PUFiling #- IV_ Lot # 2� Block #_
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Lot Sq Ft—" 5
Total Garage Sq Ft
Residential Sq Ft Comm'[ Sq Ft # of Stories Bldg Height # Dwelling Units
131 Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths s/. Baths '/ Baths # of Fireplaces
Air Conditioning: Yes No Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
LMLITIES INFO:
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s m
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)
Description of Work:--P&N (iVE-k �)GCl[
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info;
Electrical_ echanical
/ ,^_ Plumbing
Framer L( �)(q oo n Concrete Other
Applicant: I hereby acknowledge that 1 have read his application and state that the above information is correct and agree to comply with all requirements
contained herein and C' Fort s rdinances aandd state laws regulating building con truction. ,,,_ I
Applicant Signature !�! -�' Print Name M S !►lem rPhone 97oa�-I30�
Dis ribution: White - Office Yellow - Applicant Pink - VWWV/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE