HomeMy WebLinkAbout944 W MOUNTAIN AVE - APPLICATIONS - 11/28/2007BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION 3t 19
APPLICATION NUMBER b b � 01 ° 3 APPLICATION DATE u V ✓ 0
Job Site Address 144 w M omAc- — Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not ^optional) Phone # Z - 0 g34
Last Name 4 �n vwM, \ First Name A l'rt, L ✓� Middle
Street Address `L L14 W XdVA Ii` "a ' /'t VQ-- City [---I— � I � sl S �,Sptate 60 Zip
CONTRACTOR INFO: Company Name � Ci Contractor Phone # L%o2. —hCX —
Lic. Holder Name �W�S�ct :Sc• .� City of Fort Collins License # RD S-4 7 Supervisor Cert #
Mailing Address Try S1 City FA- CO) \ -AState Co Zip 5CG 2A
LEGAL INFO:
Subdivision/PUD M crrc,p„/ - Filing # 1t,33 Lot # Block # Lot Sq Ft.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
# of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft t o -11 2nd Floor Sq Ft Unfinished Bsmt Sq Ft 315 Finished Bsmt Sq Ft SP7(0(
# of Bedrooms # of Full Baths % Baths /2 Baths # of Fireplaces
Air Conditioning: Yes 'U Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
3. ResCheck w/Blower Door 4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
List appropriate option
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) $ - eQr �� . 16 91" , 4"(
Description of Work:
Contact Name & Phone # of JOBSITE SUPERVISOR: LD o rctvrt_ W , ✓l n.Lf - 5-4 Ct - 341, 6
Subcontractor Info:
Electrical �� C�e,—+rX-C, Mechanical 1 -f)�7S tYC� Af< t�t/Plumbing I'etIfLc � l� ye—,L'.t�
Framer w Lo ��r-" Roofing Concrete / Other ��'
J
Applicant: I hereby acknowle ge that I have read this application and state that the above information is correct and agree to comply with all req r m nts
contained herein and City of fort Collins ordinances and state laws regulating building construction.
Applicant Signature Print Name ��Z1n,w FTiY G���t2� Phone
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE