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HomeMy WebLinkAbout2101 S TIMBERLINE RD - APPLICATIONS - 4/24/2008City of Fort Collins f' BUILDING PERMITS &L INSPECTIONS DIVISION P.O. Box 580 Fort Collins, CO 80522-0580 • Phone: 221-6760 www fcgov com/bu lding BUILDING PERMIT APPLICATION APPLICATION NUMBER _O SSA APPLICATION DATE Z �� Job Site Address -� 0 l j tMiJ x Y ru,( hn,, Unit # PROPERTY OWNER.INFO: (All owner information is required it is not optional) Phone "# 3rj3' 5 D l— U3w V _ - Last Name i� � First Name�'., ] -_ _ ___—_ Middle _ Street Address I o5SO Q �l N -:,':City i al,\Aoll� StateD_Zip 1 CONTRACTOR INFO:. Company Name � �� Contractor Phone # . (a fl L� S IC�W 1 City of Fort Collins License # - �- Supervisor Cert # - ` Lic. Holder Name � ty _ p �9 b. G1 I� Mailing Address _� I�� Q��, �`. i�� City State �D Zip ONQ LEGAL INFO:. } Subdivision/PUD �jd[I11�Qi CJQ� Filing #_ _ Lot # M Block # Lot Sq. Ft. CONSTRUCTION INFO: Total Building Sq Ft (not including basement) `T� �© 4�F Total Garage Sq Ft _ — Q Residential Sq Ft Comm] Sq Ft 3 3 dV # of Stories 1 Bldg Height # Dwelling Units 1n Floor Sq Ft 2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft # of Bedrooms # of Full Baths % Baths '/2 Baths # of Fireplaces Air Conditioning: Lis-P No Energy info: (Circle appropriate choice) 1. ComCh 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: II t� t� Water Tap Size 1 Sewer Tap Size 4- Metered: ,es or No Temp. Pedestal: &or No Type of Heat: ji�I'Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑ 150 Amp or Less 13 200 Amp 0 Other Value of Construction (including labor, material & profit) $ � , 001D o oo Description of Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: 1• Electrical 1`W EkZ 1C.. Mechanical �Wo 13cG�r1( 1 T�� l� Plumbing iJC'X11 _�AIY1 � n - - - Framer .. Y - Roofing � _LL, Eztfrnk Concrete Other Applicant: I hereby acknowledge that I have read this application and state t 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. �1 Applicant Signature -PrintName C 11kA�'1 \ Phone %_ w Distribution: White - Office Yellow— Applicant Pink — WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE