HomeMy WebLinkAbout417 S GRANT AVE - APPLICATIONS - 12/4/2007BUILDING PERMITS & INSPECTIONS DIVISION jC-0;Z
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 /n www.fcgov.com/building
CityofFort Collins -BO--70 UILDING PERMIT APPLI ON
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APPLICATION NUMBER ��� APPLICATION DATE
Job Site Address A/AtF Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone #
Last Name A/yA First Name le0ai jj2� Middle
Street Address 4// 7 S, 67"A17 .4//.G City 1G'Z 4f OL1-//✓S State zip S -so /
CONTRACTOR INFO: Company Name ,Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City State Zip
Subdivision/PUDFiling # C/Lot Block # Lot Sq Ft
CONSTRU(;TION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
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Resid�iai Sq` t Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Bedrooms # of Full Baths 1/4 Baths t-"� % Baths # of Fireplaces
Air Conditioning: Yes No 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 # List appropriate option #s
UTILITIES INFO: O®®® 7 7 8
Water Tap Size Sewer Tap Size Metered: Yes or No •J Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only):: 1550 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ (jco
Description of Work: / j/Un - - L y lewI'%
Contact Name & Phone # of JOBSITE buPERVISOR:
Subcontractor Info:
Electrical Mechanical Plumbing
Framer Ro ing 14 Concrete Other
Applicant: I hereby acknowledge that I e read this ap ion state that the above information is correct and agree to comply with all requirements
contained herein and City o i�ort Col' s ordina a ate I egulating building construction.
Applicant Signature Print Name /t 'e-R /J` � Phone 42-71s7
Distribution: White — Office Yellow — Applicant Pink — WWW/Stormwater 6e)f �3l`Z96%
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE