HomeMy WebLinkAbout632 STOVER ST - APPLICATIONS - 4/3/2008City of Fort Collins
APPLICATION
BUILDING PERMITS & INSPECTIONS DIVISION
P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760
www.fcgov.com/building
BUILDING PERMIT APPLICATION
APPLICATION
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Job Site Address R� TG i/ e r Unit #
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PROPERTY OWNER INFO: (All o r tnfb9ation required -it is not optional)) Phone #
Last Name (<< �! First Name y GCII A / Middle
Street Address 3 drTo �� it J'Ld? Pi�j lL City /� /-c� r% �i hyy��y State�`Zip }r l/S 'y
CONTRACTOR INFO: Company Name /✓��7✓ �, c7✓ �✓'r' s�, � Contractor one'/ `� Z l
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Lic. Holder Name )2 A/ r Id CJ *�'t G l'ha City of Fort Collins License #��/Supervisor Cert #
Mailing Address P O Ate 2 7 ; j I, % City �f Cl AAJ State 60 Zip Ro 67 6__�
LEGAL INFO: /�
Subdivision/PUD % 0 / .� 6 '— x nciR .1�ig # Lot # Block # Lot Sq Ft
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) �, (O Total Garage Sq Ft
Residential Sq Ft Comm'I Sq
# of Stories / Bldg Height # Dwelling Units
1st Floor Sq Ft /DD D 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft �OOa
# of Bedrooms - tam # of Full Baths / 007cx - - % Baths '/2 Baths # of Fireplaces w�
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
Energy info: (Circle appropriate choice) 1. ComCheck
4. E-Star w/Blower Door 5. Prescriptive w/Air Sealing
List appropriate option
2. ResCheck w/Air Sealing
6. Prescriptive w/Blower Door
UTILITIES INFO: 1`r �
Water Tap Size Sewer Tap Size Metered: Yes or No Temp. Pedestal: Yes or No \�
Type of Heat: )dGas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other
Value of Construction (including labor, material & profit)
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Contact Name & Phone # of JOBSITE SUPERVISOR:
Subcontractor Info: �./� J� /1 eke P1 6
Electrical. (ter n cal�Ul/Ar�� /!/P, Plumbing ( �n/leC�h
Framer��i//NB ��ccrl/gzzZ� oofing /�i� Concrete �- Other E
Applicant: I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with al requiremen
contained herein and City o on Collins ordi es d state laws regulating building construction.
Applicant Signature .? 1 Print Name 4alyi, //, 10,&;ArA Ph ne
Distribution: White - Office Yellow - Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE