HomeMy WebLinkAbout925 ALEXA WAY - APPLICATIONS - 1/25/2006" 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 (/ (Y�� D APPLICATION DATE_
Job Site Address 9a s Al Pxa I�" r� C I , Q'VT4 Unit # —'
PROPERTY OWNER INFO: (All owner information is required - it is not optional) Phone # 79 S-d/ 7 0
Last Name \ Ouvi C First Name4%i' Middle
Street Address 9a lei.' City /'� Go i' /i ry' State Co zip l� u
_ S�
CONTRACTOR INFO: Company Name rrah COv►c� i,rycfi�r,pCo tractor Phone # Cg7 6)�f9 3- 1p % c3 '
Lic. Holder Name_ �P� ,�� /r c� City of Fort Collins License # Supervisor Cert #
Mailing Address City
LEGAL INFO:
State zi
Subdivision/PUD (. /areh cr ,, }- /ij Filing # Z- Lot # Block # Lot Sq Ft
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
# of Bedrooms # of Full Baths
Air Conditioning: Yes No
3. ResCheck w/Blower Door
City of Fort Collins Stock Plan #
UTILITIES INFO:
Unfinished Bsmt Sq Ft LOZ�� Finished Bsmt Sq Ft
% Baths '/2 Baths # of Fireplaces
Energy info: (Circle appropriate choice) 1. ComCheck 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) $_ 11 GJo1
Description of Work (jS CeVa ( n b e,.,py
Contact Name & Phone # of JOBSITE SUPERVISOR: it- 64r,0_1, y93- 617j—
Subcontractor Info:
Electrical C'l-LAd ")+'e,/c f Mechanical
Framer
Plumbing A2L) _
11
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.
Applicant Signature % Print Name yvUvt Phone 5 � `6/ 7-2—
istribution: White — Office Yellow — Applicant Pink — WWW/S ormwater
Roofing
Concrete
THIS APPLICATION EXPIRES 90 DAYS FROM APPLICATION DATE