HomeMy WebLinkAbout4809 CHIPPENDALE DR - APPLICATIONS - 1/3/2006�~ BUILDING 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 NUMBER V 0 V APPLICATION DATE 11310(,
Job Site Address 4groq Ch.VjD&dAI nin1tP .=rl,Cal��n5 WSDD-� Unit #
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # -
Last Name �61 Y, First Name 5�tS (4, Y\ Middle s. Street Address Ito bwxA dal( ;IX1IVc City iCotIPLS State t�i� Zip FbsaIL
CONTRACTOR INFO: Company Name I Contractor Phone #
Lic. Holder Name City of Fort Collins License # Supervisor Cert #
Mailing Address City
LEGAL INFO:
Subdivision/PUD aye ?-SGI q-e- Filing #.
CONSTRUCTION INFO: Total Building Sq Ft (not including basement) _
Lot #F
State Zip
, �'//j �'/' � -
Block # Lot Sq Ft . 9� ov
Total Garage Sq Ft ll�
Residential Sq Ft Comm] Sq Ft # of Stories Bldg Height # Dwelling Units
1s' Floor Sq Ft
# of Bedrooms
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
2nd Floor Sq Ft Unfinished Bsmt Sq Ft Finished Bsmt Sq Ft
# of Full Baths 3/4 Baths '/z Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 2. ResCheck w/Air Sealing
4. E-Star w/Blower Door
Water Tap Size Sewer Tap Size
5. Prescriptive w/Air Sealing 6. Prescriptive w/Blower Door
List appropriate option #s
Metered: Yes or No Temp. Pedestal: Yes or No
Type of Heat: ❑ Gas ❑ Electric Electric Main Breaker Size (Residential only): ❑1150
Value of Construction (including labor, material & profit) $ Z9 �
Description of Work:
or Less ❑ 200 Amp ❑ Other
Contact Name & Phone # of JOBSITE SUPERVISOR: ( �61 1 roo Y-- �ba.-d 30 ceii 4PP'13ID-
Subcontractor Info: �'A
Electrical
Framer
Roofing
Mechanical
Concrete
Plumbing
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. ''ii,, p�
Applicant Signature Print Name �ilA §, 4hI6i
rpbK Phone C)
Distribution: White - Office Yellow -Applicant Pink - WWW/Stormwater
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE