HomeMy WebLinkAbout625 ARMSTRONG AVE - APPLICATIONS - 4/25/2008City of Fort Collins
APPLICATION
Job Site Address
PROPERTY OWNER INFO:
Last Name fJM---" S
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 8057.2-0580 • Phone: 221-6760
www.fcgov com/building
BUILDING PERMIT APPLICATION
APPLICATION
Z5 ld:Ll , Unit#
(All owner information is required it is not optional) Phone # �O �/ Z'��2%
First Name /I6%0 lav- Middle
Street Address 6Z5 �{�T �rtZpr'�T A"� City Stag. Zip&,VS'Z
CONTRACTOR INFO: Company Namey- ������5 10G Contractor Phone
Lic. Holder Name pmo I1ICf,L,. City of Fort Collins License #D11"'I Supervisor Cert #
Mailing Address 32 tcj� City_�� 1`J State <<? Zip �S�
LEGAL INFO:
Subdivision/PUD
Filing # Lot # Block # Lot Sq
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 Finished Bsmt Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
# of Full Baths s/ Baths /2 Baths # of Fireplaces \ l�
Energy info: (Circle appropriate choice) 1. Corri 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
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: 7'V li7r'*a �
IIIIIIIIII%�Z-_i .►� '► _.�r:.I. 7i
Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info::,
Electrical Mechanical � `T 7 1 yr� 1 � Plumbing �/
Framer JP
Roofing .i -iz�Toii Concrete Jr/ 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. Imo' -7
Applicant Signature 6r% Print Name�� �I V Phone 2Z /-4 ZZ
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE