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HomeMy WebLinkAbout6107 PHILLIPS DR - APPLICATIONS - 12/8/2005BUILDING PERMITS & INSPECTIONS DIVISION P.O. Box 580 • Fort Collins, CO 80522-0580 • Phone: 221-6760 www.fcgov.com/building City of Fort Collins BUILDING PERMIT APPLICATION APPLICATION NUMBERyAPPLICATION DATE Job Site Address ( 0 / A I 'A V b (' Unit # PROPERTY OWNER INFO: (All owner information is required — it is not optional) Phone # 70 �c9 ©q�� Last Name /' c Co ld First Name � . Middle JCO �- T Street Address (61 0 -7 0 ,r City '�' . �, /1S State W Zip 'RO �5 '� S- CONTRACTOR INFO: Company Name S�k� Contractor Phone # Lic. Holder Name Mailing Ad LEGAL INFO: City of Fort Collins License # City, State Supervisor Cert # M Subdivision/PUD t}trr��`t tr�q �c7v� W MS Filing # Lot # �� Block # Lot Sq Ft 1 E;Z3 CONSTRU ON 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 # of Full Baths '/4 Baths '/2 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- r 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 Bre'�ker Size (Residential only): ❑ 150 Amp or Less ❑ 200 Amp ❑ Other Value of Construction (including labor, material & profit) $ Contact Name & Phone # of JOBSITE SUPERVISOR: Subcontractor Info: Electrical Mechanical Plumbing Framer Roofing 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 Fo Collins ordinances and state laws regulating building construction. li (�/� /1 e c Applicant Signature C Print Name -O' T l � l CCO4 Phone Sq� —0(4 0 L Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE