HomeMy WebLinkAbout4226 CENTER GATE CT - APPLICATIONS - 3/7/2008BUILDING PERMITS & INSPECTIONS DIVISION Gf 1059 13
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
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City of Fort Collins BUILDING PERMIT APPLICATION
APPLICATION NUMBER �OIJC/ I `Ct J 1 APPLICATION DATE 17 �— aZ
Job Site Address y�22% CO -e-r Ca�e_ cla - Uniit#
PROPERTYOWNERINFO: (All owner information is required - it is not optional)
A) I Phone # Ao7 - I G 1g
Last Name 1 l raJy✓t�`` on ` � First Name 4� 6 MOV-i Cl -) Middle /
Street AddressyZZ(o C�nd"� &� /^ citty(F' - Colkin_g State CA Zip t0
CONTRACTOR INFO: Company Name 1'UG�) rrtq�,� t_-cy►,5 , Contractor Phone #,274& - /9 - o
Lic. Holder Name Ftcin4 W r2'10'r't el City of Fort Collins License # G i - 131 Supervisor Cert # �J'M
Mailing Address �7I W. City L011-e14, r)oi State Co Zip
LEGALINFO
Subdivision/PUD Filing # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) Total Garage Sq Ft
Residential Sq Ft Comm'I Sq Ft # of Stories Bldg Height # Dwelling Units
1st Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft 3l//o Finished Bsmt Sq Ft �• 2�
# of Bedrooms # of. Full Baths — C) 3/< Baths 1 '/z 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:
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 Constructions ((including labor, material & profit) $ s�j ` 400
Description of Work: F /'+t3t1 )PAS irtW¢„ lef> fn djrwn� 2 bWJ' KDeen $ C-f 6e'k zj eld
cAzc-- ► %oo rri w i ) &v e+ &ry-
Ek 4t-CC,'- Ua Is li¢d-Z A_n:5 U,n er lerrl'Pr'I& 1' gOZO 9-7iSQ
Contact Name & Phone # of JOBSITE SUPERVISOR: G6(4r, rr i j - 567- 002&
Subcontractor Info
Electrical l J I-e-S u(t/I �G Mechanical Ou(' t crl (201 o(cdo Plumbing U ck-ndo Brn Mt i)-
Framer gaen Roofing AJ1141 Concrete Other
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 City of Fort Collins ordinances and state laws regulating building construction.
Applicant Signature _ � Print Name MoG 44zam Phone 2 / �7 � ` 193d
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE