HomeMy WebLinkAbout118 S WHITCOMB ST - APPLICATIONS - 11/1/2007BUILDING PERMITS & INSPECTIONS DIVISION'(��
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 r
www.fcgov.com/building
City of Fort Collins BUILDING PERMIT APPLICATION R 3
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APPLICATION NUMBER O l "'�L 1 a APPLICATION DATE
Job Site Address u b -5 PL` L0 Ado 5j- Unit #
PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # iia0 - (a 3q ;j
Last Name %►k-ou First Name U-C\ Middle
ry
Street Address \\� •w �L' orh Y� City _ Cy l� tf\�j State Lo Zip b$ 1
CONTRACTOR INFO: Company Name`
Lic. Holder Name L.Qfmft-
E
Mailing Address Sow\ e_
LEGAL INFO:
Subdivision/PUD
Contractor Phone #
City of Fort Collins License # a 3 b Supervisor Cert #
City
State Zip
Filing # Lot # Block # Lot Sq
CONSTRUCTION INFO: Total Building Sq Ft (not including basement)
Residential Sq Ft Comm'I Sq Ft
1st Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Total Garage Sq Ft 5 Qq
# of Stories Bldg Height # Dwelling Units
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/4 Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
Water Tap Size Sewer Tap Size
List appropriate option
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 15001Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit) $ t' po , a _r 5j a'`/
Description
x
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info:
Electrical LI S-SP�SAH Mechanical Plumbing
Framer \E Roofing V!,'` &A Concrete Other
Applicant: I hereby accnowledge 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 of Fort Collins ordinances and state laws regulating building construction. t G
Applicant Signature Print Name -1i to e. `� Phone M o - fp 707
Distribution: ite -Office Yellow -Applicant Pink - WWW/Stor water
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE